Urinalysis (automated, with microscopy)
Facility: Cloud County Health Center
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $44
- Cash Discount Price: $33
- vs. Medicare Baseline: 13.88x 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 1388% of the Medicare baseline (a markup of 1288%). 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 |
|---|---|---|
| Aetna | $42 - $43 | 1325% |
| Pponext-All Plans | $44 | 1388% |
| Mpi-All Plans | $44 | 1388% |
| Health Partners - All Plans | $44 | 1388% |
Consumer Guidance & Cost Commentary
For the Urinalysis (automated, with microscopy) procedure at Cloud County Health Center in Concordia, KS, the facility's cash median rate is $33.00, which is lower than the negotiated rates of $44.00 paid by major payers like Aetna, Pponext-All Plans, Mpi-All Plans, and Health Partners - All Plans. While the facility is a Critical Access Hospital owned by a voluntary non-profit, patients with high-deductible plans may find paying the cash price of $33.00 more cost-effective than relying on insurance, as the negotiated rate of $44.00 exceeds the cash amount. It is important to note that commercial rates often include administrative overhead and contract dynamics that can inflate the baseline price, so verifying self-pay or prompt-pay discounts directly with the hospital before scheduling can help secure the lowest possible out-of-pocket cost.
This service is billed under CPT code 81001, and the facility's cash rate of $33.00 is significantly lower than the Medicare amount of $3.17, indicating a substantial markup relative to the federal government's fixed reimbursement baseline. Although the data does not provide specific state or county average comparisons for this procedure, the disparity between the cash price and the Medicare benchmark highlights the importance of understanding the true cost of care rather than relying on the facility's gross charge of $47.00. Patients should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, it is still advisable to request a full itemized bill to ensure no unbundled codes or services not rendered are included in the final invoice.