Urinalysis (automated, with microscopy)
Facility: Greenwood County Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $63
- Cash Discount Price: $59
- vs. Medicare Baseline: 19.87x 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 1987% of the Medicare baseline (a markup of 1887%). 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 |
|---|---|---|
| UnitedHealthcare | $2 - $62 | 63% |
| Blue Cross Blue Shield | $9 - $10 | 284% |
| Triwest - All Plans | $26 | 820% |
| Tricare | $31 | 978% |
| Choicecare Mcr Adv - All Plans | $31 | 978% |
| Integrated Health Plan - All Plans | $56 | 1767% |
| First Health Ccn Network | $63 | 1987% |
| Beech Street - All Plans | $63 | 1987% |
| First Health - All Other Plans | $63 | 1987% |
| Preferred Hs (Coventry) - All Plans | $67 | 2114% |
| Principal Health Care Inc - All Plans | $70 | 2208% |
| Amerigroup Mcaid-All Plans | $74 | 2334% |
| Medicaid / KanCare | $74 | 2334% |
| Providrs Care/Wppa - All Plans | $111 | 3502% |
Consumer Guidance & Cost Commentary
For this urinalysis procedure at Greenwood County Hospital in Eureka, Kansas, the facility's cash price of $59.00 is lower than the state average of $63.00, making it a competitive option for self-pay patients. While the median negotiated rate for in-network insurance plans is $63.00, which is slightly higher than the cash price, patients with high-deductible plans may find paying out-of-pocket more cost-effective if their insurance allowed amount exceeds the cash rate. It is important to note that while the facility is a Critical Access Hospital owned by the local government, commercial insurance contracts often include administrative overhead that can inflate the negotiated rate above the direct cash price.
To ensure you receive the most accurate billing, always request a full itemized bill before paying, as summary invoices can hide unbundled charges or services not rendered. If you receive a balance bill for out-of-network services, remember that the No Surprises Act generally protects you from paying the difference between the provider's full charge and your insurance allowed amount for emergency or non-emergency care at in-network facilities. Additionally, ask the hospital about prompt-pay discounts, which can reduce your total bill by 20% to 50% if you pay upfront, bypassing the administrative costs associated with insurance claims processing.