Urinalysis (automated, with microscopy)
Facility: Mitchell County Hospital Health Systems
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $54
- Cash Discount Price: $51
- vs. Medicare Baseline: 17.03x 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 1703% of the Medicare baseline (a markup of 1603%). 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 - $57 | 95% |
| Blue Cross Blue Shield | $10 | 315% |
| Triwest Well Mark All Plans | $48 | 1514% |
| First Health-All Plans | $51 | 1609% |
| Pref Hlth Care Sytms Comm - All Plans | $51 | 1609% |
| Aetna | $51 | 1609% |
| Multiplan Ppo - All Plans | $54 | 1703% |
| Auxiant-All Plans | $54 | 1703% |
| Phc Leased Ntwrk Access - All Plans | $54 | 1703% |
| Cigna | $56 | 1767% |
| Health Partners Ks-All Plans | $56 | 1767% |
Consumer Guidance & Cost Commentary
For this automated urinalysis procedure at Mitchell County Hospital Health Systems in Beloit, KS, the facility's negotiated rates range from $3 to $57, with a median negotiated amount of $54. This commercial rate is significantly higher than the facility's cash price of $51 and exceeds the state average for this service. While Medicare reimbursement is set at $3.17, the cash price remains the most affordable option for patients without insurance or those with high-deductible plans, as paying out-of-pocket avoids the administrative markup inherent in insurance billing cycles. Patients should verify their specific plan's deductible status before scheduling, as utilizing insurance may result in higher out-of-pocket costs if the negotiated rate exceeds the patient's allowed amount.
To minimize potential financial exposure, consumers should proactively request a self-pay classification and inquire about prompt-pay discounts, which can reduce the total cost by 20% to 50% when paid upfront. It is also advisable to obtain a full itemized bill containing specific CPT codes rather than accepting a summary invoice, as these detailed statements help identify unbundled charges or services not rendered. If a patient receives a balance bill from an out-of-network provider at this in-network facility, they may be entitled to protections under the No Surprises Act, which prohibits balance billing for emergency and non-emergency services. Disputing any unexpected charges in writing with the billing supervisor is the most effective way to ensure fair pricing and avoid surprise costs.