Urinalysis (automated, with microscopy)
Facility: Scott County Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $51
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 16.09x 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 1609% of the Medicare baseline (a markup of 1509%). 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 | $3 - $54 | 95% |
| Blue Cross Blue Shield | $10 | 315% |
| Humana | $24 | 757% |
| Wppa | $34 - $1,200 | 1073% |
| Aetna | $51 | 1609% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Scott County Hospital in Scott City, KS, has a gross charge of $57.00. The facility's negotiated rates range from $3 to $1,200 across five payers, with a median negotiated amount of $51.00. This service is provided at a Critical Access Hospital, a facility type often associated with streamlined billing practices. While the data does not provide specific cash or state/county average figures for this exact procedure, patients should be aware that cash-pay options can sometimes result in lower out-of-pocket costs than insurance negotiated rates, particularly for those with high-deductible plans. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts before scheduling, as these upfront incentives can significantly reduce the final bill.
The Medicare benchmark for this service is $3.17, which serves as a critical baseline for evaluating pricing fairness. The facility's gross charge of $57.00 represents a 16.1% increase over the Medicare amount, indicating the markup applied to this specific test. When reviewing your itemized bill, ensure you are comparing the final allowed amount to the Medicare rate rather than the inflated chargemaster list price, as commercial rates often average 200% to 300% of Medicare. If you receive a summary bill, request a full itemized statement to verify that no unbundled codes or services not rendered have been charged. Additionally, if you are an out-of-network patient, remember that the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network