Urinalysis (automated, with microscopy)
Facility: Clay County Medical Center
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $41
- Cash Discount Price: $44
- vs. Medicare Baseline: 12.93x 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 1293% of the Medicare baseline (a markup of 1193%). 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 |
|---|---|---|
| Multiplan- All Plans | $41 | 1293% |
| UnitedHealthcare | $41 | 1293% |
| Wppa/Providrs Care- All Plans | $41 | 1293% |
| Health Partners - All Plans | $41 | 1293% |
| Aetna | $41 | 1293% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Clay County Medical Center in Clay Center, KS, has a cash price of $44.00 and a median negotiated rate of $41.00 across five major payers, including UnitedHealthcare and Aetna. This cash price is $12.90 higher than the state average, though the facility's negotiated rate aligns with the median paid amount of $41.00. Because commercial insurance contracts often include administrative overheads that push negotiated rates above cash prices, patients with high-deductible plans may find paying the $44.00 cash price directly more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if their deductible has not been met.
To ensure you are not overcharged, it is important to distinguish between the facility's gross charges and the actual amounts billed. While the gross charge is $44.00, the Medicare benchmark for this service is significantly lower at $3.17, indicating that the commercial rate represents a substantial markup over the federal baseline. If you receive a bill, always request an itemized statement to verify that no services were unbundled or that charges for items not rendered were included. Additionally, ask the billing department about "self-pay" or "prompt-pay" discounts, as paying upfront can sometimes reduce the total amount owed, though you should confirm that signing any consent waivers does not inadvertently waive your rights to dispute out-of-network balance billing under the No Surprises Act.