Urinalysis (automated, with microscopy)
Facility: Kiowa District Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $37
- Cash Discount Price: $31
- vs. Medicare Baseline: 11.67x 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 1167% of the Medicare baseline (a markup of 1067%). 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 |
|---|---|---|
| Healthchoice-All Plans | $5 | 158% |
| Blue Cross Blue Shield | $10 | 315% |
| Tricare | $15 | 473% |
| UnitedHealthcare | $31 - $39 | 978% |
| Health Partners Of Ks-All Plans | $34 | 1073% |
| Humana | $35 | 1104% |
| Gbs Insurance - All Plans | $37 | 1167% |
| Multiplan-All Plans | $37 | 1167% |
| Medicare (plans) | $37 | 1167% |
| Triwest-All Plans | $37 | 1167% |
| Aetna | $37 | 1167% |
| Medicaid / KanCare | $39 | 1230% |
| Providers Care (Wppa)-All Plans | $58 | 1830% |
| Liberty Healthshare-All Plans | $63 | 1987% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Kiowa District Hospital in Kiowa, KS, has a cash median price of $31.00, which is lower than the facility's negotiated median paid rate of $37.00. This facility is a Critical Access Hospital owned by a Government Hospital District, and its pricing is benchmarked against the federal Medicare rate of $3.17. While the negotiated rates for various payers range from $5 to $63, the cash price remains the most consistent baseline for patients without insurance. It is important to note that for patients with high-deductible plans, paying the cash price of $31.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. Patients should explicitly request self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can further reduce the final bill.
The facility's pricing structure reflects standard commercial dynamics where negotiated rates are higher than cash prices due to administrative costs and contract structures. Although the data does not provide specific state or county average comparisons for this procedure, the facility's cash rate of $31.00 serves as a clear reference point against which commercial rates vary significantly. To ensure transparency, patients should always request an itemized bill to verify that all charges are accurate and that no services were unbundled or double-billed. If a patient receives a balance bill from an out-of-network provider, they have the right to dispute the amount under federal protections, but for in-network services at this facility, the cash price remains the most predictable and potentially lowest cost option.