Urinalysis (automated, with microscopy)
Facility: St Luke Hospital & Living Center
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $24
- Cash Discount Price: Unavailable
- 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 |
|---|---|---|
| UnitedHealthcare | $24 | 757% |
| Bluestem Pace | $24 | 757% |
| Humana | $24 | 757% |
| Kansas Department Of Health And Environment | $24 | 757% |
| Blue Cross Blue Shield | $24 | 757% |
| Va Ccn | $24 | 757% |
| Ambetter / Centene | $25 | 789% |
Consumer Guidance & Cost Commentary
For patients at St Luke Hospital & Living Center in Marion, KS, the negotiated rate for an automated urinalysis with microscopy is $24.00, which aligns exactly with the lowest and highest negotiated amounts reported across all seven payers, including UnitedHealthcare, Humana, and Blue Cross Blue Shield. This rate is significantly higher than the Medicare benchmark of $3.17, reflecting the standard administrative markup associated with commercial insurance contracts. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data indicates no specific cash or median paid rates were reported for this service, meaning patients with high-deductible plans should verify if self-pay or prompt-pay discounts are available before scheduling to potentially lower their out-of-pocket costs.
It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected ancillary charges can still occur if specific lab components are billed separately. Consumers should request a full itemized bill before paying to ensure no unbundled codes or services not rendered are included, as summary bills often obscure these errors. Given that the negotiated rate of $24.00 exceeds the Medicare rate by over seven times, patients are encouraged to contact the billing department directly to confirm their specific plan's allowed amount and inquire about any prompt-pay discounts that could reduce the final charge if they choose to pay in full upfront.