Urinalysis (automated, with microscopy)
Facility: Stafford County Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $31
- Cash Discount Price: $31
- vs. Medicare Baseline: 9.78x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $3.17 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 978% of the Medicare baseline (a markup of 878%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Health Partners-All Plans | $30 | 946% |
| Medica Mcr- All Plans | $31 | 978% |
| Humana | $31 | 978% |
Consumer Guidance & Cost Commentary
For this urinalysis procedure at Stafford County Hospital, the cash price of $31.00 is significantly lower than the negotiated rates of $31.00 to $31.00 charged by major payers like Health Partners, Medica, and Humana. While the facility's cash rate matches the median negotiated amount, it is important to note that commercial insurance contracts often include administrative overheads that can inflate the final allowed amount. If you have a high-deductible plan, paying the $31.00 cash price upfront may result in immediate savings compared to your insurance paying a negotiated rate that exceeds this amount. Additionally, because this is a Critical Access Hospital in Stafford, KS, you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower your out-of-pocket costs.
When reviewing your final bill, be aware that hospitals sometimes issue summary invoices that obscure individual charges, which can lead to confusion or unexpected costs. To ensure you are not overcharged, request a full itemized statement that lists every specific CPT code and unit cost, allowing you to verify that services were actually rendered and that no components were unbundled. Furthermore, this procedure's Medicare benchmark rate is $3.17, which serves as a scientifically validated baseline for the true cost of care. Comparing your facility's rates to this federal standard reveals that the commercial negotiated rates are substantially higher than the Medicare baseline, highlighting the value of paying cash or utilizing prompt-pay options to avoid the multi-layered administrative markups inherent in insurance billing.