Urinalysis (automated, with microscopy)
Facility: Stanton County Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $60
- Cash Discount Price: $63
- vs. Medicare Baseline: 18.93x 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 1893% of the Medicare baseline (a markup of 1793%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $9 - $60 | 284% |
| Healthy Blue Mcr Adv - All Other Plans | $62 | 1956% |
| Healthy Blue Mcaid | $63 | 1987% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Stanton County Hospital in Johnson, KS, lists a cash median price of $63.00, which matches the facility's gross charge. This cash rate is significantly lower than the state average, as indicated by the 18.9% variance compared to Medicare benchmarks, suggesting the facility's pricing is competitive relative to the broader market. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that cash-pay options can sometimes be more affordable than insurance coverage, particularly for those with high-deductible plans where the insurer's negotiated rate might exceed the cash price. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can further reduce out-of-pocket costs.
Insurance data shows that three payers have negotiated rates for this service, ranging from $9 to $63 depending on the specific plan, with a median negotiated amount of $60.00. Although the median paid amount of $61.00 is slightly higher than the cash rate, the wide variance in payer rates—from as low as $9 to $63—highlights the importance of verifying your specific plan's allowed amount. Patients should avoid accepting summary bills without requesting a full itemized statement to ensure no errors, such as unbundled codes or services not rendered, are included in the final invoice. Furthermore, if you receive a balance bill from an out-of-network provider at this in-network facility, you may be entitled to protections under the No Surprises Act, which bans surprise billing for emergency and non