Urinalysis (automated, with microscopy)
Facility: Osborne County Memorial Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $19
- Cash Discount Price: $18
- vs. Medicare Baseline: 5.99x 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 599% of the Medicare baseline (a markup of 499%). 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 | $16 | 505% |
| Health Partners Of Kansas | $18 | 568% |
| Wppa | $20 | 631% |
| Blue Cross Blue Shield | $21 | 662% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, representing an automated urinalysis with microscopy, Osborne County Memorial Hospital in Osborne, Kansas, lists a cash price of $18.00. This cash rate is slightly higher than the facility's own negotiated average of $19.00, though it remains competitive relative to the state of Kansas, where the average cash price for this service is $18.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that insurance negotiated rates can sometimes exceed cash prices; for instance, UnitedHealthcare and Health Partners Of Kansas both have a negotiated rate of $16.00, which is lower than the cash price. However, if a patient has a high deductible plan, paying the cash price of $18.00 upfront may result in lower out-of-pocket costs compared to the insurance allowed amount, provided the deductible has not yet been met.
When comparing this service to federal benchmarks, the Medicare amount for this procedure is $3.17, which serves as a baseline for evaluating the facility's pricing structure. The facility's cash price of $18.00 represents a significant markup over the Medicare rate, a common occurrence in commercial healthcare pricing where administrative costs and profit margins are factored in. It is important for consumers to request an itemized bill before paying, as hospitals may issue summary invoices that obscure individual charges or include unbundled codes for services not rendered. Additionally, patients should inquire about prompt-pay discounts, which can reduce the final balance by 20% to 50% if paid in full within a short window, effectively bypassing the administrative overhead associated with insurance