Urinalysis (automated, with microscopy)
Facility: Hodgeman County Health Center
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $57
- Cash Discount Price: $65
- vs. Medicare Baseline: 17.98x 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 1798% of the Medicare baseline (a markup of 1698%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $9 - $10 | 284% |
| Triwest - All Plans | $52 | 1640% |
| Medicaid / KanCare | $52 - $81 | 1640% |
| UnitedHealthcare | $52 - $77 | 1640% |
| Humana | $52 | 1640% |
| Aetna | $65 | 2050% |
| First Health - All Plans | $73 | 2303% |
| Wppa (Provdrscare) - All Plans | $77 | 2429% |
| Health Partners - All Plans | $77 | 2429% |
Consumer Guidance & Cost Commentary
For the Urinalysis (automated, with microscopy) procedure at Hodgeman County Health Center in Jetmore, Kansas, the cash median price is $65.00, which aligns closely with the facility's negotiated rates of $57.00 and the state average of $61.00. While commercial payers like Blue Cross Blue Shield and UnitedHealthcare have negotiated rates ranging from $52.00 to $81.00, these amounts often exceed the cash price due to administrative overheads and contract structures. Patients with high-deductible plans may find paying the cash rate of $65.00 directly more cost-effective than relying on insurance, as the insurer's allowed amount could be higher than the cash price, potentially leading to balance billing if the patient is out-of-network for this specific service.
To ensure you receive the most accurate pricing, it is essential to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, you should inquire about prompt-pay discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing the costly insurance claims cycle. If you receive a surprise bill that exceeds the negotiated rate, you may be eligible for protections under the No Surprises Act, which bans balance billing for out-of-network services at in-network facilities. Always verify your specific plan's deductible status and ask the facility to classify your account as self-pay to secure the lowest possible rate.