Urinalysis (automated, with microscopy)
Facility: Republic County Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $33
- Cash Discount Price: $27
- vs. Medicare Baseline: 10.41x 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 1041% of the Medicare baseline (a markup of 941%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $31 | 978% |
| Aetna | $32 | 1009% |
| Meritain-All Plans | $32 | 1009% |
| UnitedHealthcare | $33 | 1041% |
| Midlands Choice-All Plans | $34 | 1073% |
| First Health-All Plans | $34 | 1073% |
| Cigna | $34 | 1073% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Republic County Hospital in Belleville, KS, lists a cash median price of $27.00, which is lower than the facility's negotiated rates of $33.00 and the state average of $34.00. While the facility's cash rate is also below the national average of $36.00, patients with high-deductible plans may find paying out-of-pocket initially more cost-effective than using insurance, as the commercial negotiated rates exceed the cash price. It is important to note that the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, and patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to ensure they receive the lowest possible rate.
The Medicare benchmark for this service is $3.17, which serves as the objective baseline for evaluating pricing markups. The facility's cash rate of $27.00 represents a significant markup over the Medicare amount, consistent with commercial pricing structures where negotiated rates often average 200% to 300% of the Medicare rate. If you receive an itemized bill for this procedure, you should verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute. Always compare the final allowed amount to the Medicare rate rather than the hospital's gross chargemaster to understand the true cost of care.