Urinalysis (automated, with microscopy)
Facility: Great Plains Of Sabetha
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $24
- Cash Discount Price: $25
- vs. Medicare Baseline: 7.57x 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 757% of the Medicare baseline (a markup of 657%). 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 |
|---|---|---|
| Celtic Mcr Adv | $13 | 410% |
| Aetna | $13 - $25 | 410% |
| Celtic Comm Exchange-All Other Plans | $16 | 505% |
| Great West Healthcare-All Plans | $21 | 662% |
| UnitedHealthcare | $23 - $25 | 726% |
| Humana | $24 | 757% |
| Century/Wppa/Providers-All Plans | $24 | 757% |
| Cigna | $24 | 757% |
| Multiplan-Phcs-All Plans | $24 | 757% |
| Federated Mutual Ins-All Plans | $24 | 757% |
| Blue Cross Blue Shield | $25 | 789% |
| Medicaid / KanCare | $25 | 789% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Great Plains Of Sabetha in Sabetha, KS, lists a cash median price of $25.00. This cash rate is notably higher than the state average, which is $21.00. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates ranging from $13 to $25, these negotiated amounts often exceed the cash price. For patients with high-deductible plans, paying the cash rate of $25.00 upfront can be more cost-effective than relying on insurance, which may result in higher out-of-pocket costs if the deductible has not yet been met. Patients are encouraged to contact the facility directly to inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% when paid in full within a short window.
The facility's Medicare benchmark for this service is $3.17, which serves as a baseline for evaluating the markup on commercial rates. Commercial negotiated rates for this procedure average between 200% and 300% of the Medicare amount, whereas fair pricing is typically defined as 120% to 150% of the Medicare rate. Given that the facility is a Critical Access Hospital owned by a voluntary non-profit, patients should request an itemized billing audit to ensure no errors, unbundled codes, or services not rendered are included in the final invoice. It is important to avoid paying balance bills immediately; instead, patients should verify the legality of any surprise charges and request a formal audit dispute if discrepancies are found.