Urinalysis (automated, with microscopy)
Facility: Girard Medical Center
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $28
- Cash Discount Price: $48
- vs. Medicare Baseline: 8.83x 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 883% of the Medicare baseline (a markup of 783%). 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 | $10 - $28 | 315% |
| Humana | $28 | 883% |
| Kansas Superior Select-All Plans | $28 | 883% |
| Aetna | $28 - $140 | 883% |
| UnitedHealthcare | $28 - $76 | 883% |
| Ambetter / Centene | $28 | 883% |
| Medicare (plans) | $28 | 883% |
| Multiplan-All Plans | $74 | 2334% |
| Uhhis-All Plans | $76 | 2397% |
Consumer Guidance & Cost Commentary
For this automated urinalysis procedure at Girard Medical Center in Girard, Kansas, the cash median price is $48.00, which is lower than the negotiated rates paid by most major insurers. While the facility's cash price is higher than the national average for this service, it remains below the negotiated amounts charged by payers such as Aetna (up to $140) and UnitedHealthcare (up to $76). Patients with high-deductible plans or those who have met their out-of-pocket limits may find paying the cash price directly more cost-effective than relying on insurance, as the commercial negotiated rates often exceed the cash rate. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final bill.
The facility's billing practices align with standard industry benchmarks, with a median negotiated rate of $28.00 and a Medicare amount of $3.17. Although the facility is a Critical Access Hospital with a government ownership structure, the pricing reflects typical commercial markup dynamics where negotiated rates can range significantly, from $10 to $140 depending on the insurance plan. Consumers should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, it is still important to request an itemized bill to verify all charges. If any unexpected costs arise, patients should dispute the bill in writing rather than accepting summary invoices, ensuring that all services rendered are accurately coded and that no unbundled charges or errors inflate the total.