Urinalysis (automated, with microscopy)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $13
- Cash Discount Price: $14
- vs. Medicare Baseline: 4.10x 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 410% of the Medicare baseline (a markup of 310%). 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 |
|---|---|---|
| Humana | $8 | 252% |
| Tricare | $8 | 252% |
| Medicaid / KanCare | $10 - $16 | 315% |
| Aetna | $10 - $14 | 315% |
| UnitedHealthcare | $10 - $16 | 315% |
| Ambetter / Centene | $11 | 347% |
| Blue Cross Blue Shield | $13 | 410% |
| Health Partners - All Plans | $15 | 473% |
| Healthy Blue Mcaid - All Plans | $16 | 505% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Trego County Lemke Memorial Hospital in Wakeeney, KS, has a cash median price of $14.00 and a median negotiated rate of $13.00. This cash price is $1.00 lower than the facility's negotiated rate, which is a notable exception to the typical trend where insurance payments exceed cash prices. The facility's cash rate is also $1.00 higher than the state average of $13.00, though it remains below the gross charge of $16.00. Patients with high-deductible plans may find this cash price advantageous, as it avoids the administrative overhead and potential higher negotiated rates often seen with insurance claims.
The facility is a Critical Access Hospital owned by the local government, and while it participates with nine payers including Humana, Tricare, and Medicaid/KanCare, specific negotiated amounts vary by plan. For instance, Medicaid/KanCare plans range from $10.00 to $16.00, while Aetna plans range from $10.00 to $14.00. To minimize costs, patients should request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50%. It is also important to verify that no balance billing will occur, as the No Surprises Act protects patients from unexpected out-of-network charges for emergency or non-emergency services at in-network facilities.