Urinalysis (automated, with microscopy)
Facility: Smith County Memorial Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $23
- Cash Discount Price: $24
- vs. Medicare Baseline: 7.26x 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 726% of the Medicare baseline (a markup of 626%). 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 | 315% |
| Medicaid / KanCare | $17 - $24 | 536% |
| Multiplan-All Plans | $22 | 694% |
| UnitedHealthcare | $23 | 726% |
| Health Partners Of Ks Ppo-All Plans | $23 | 726% |
| Midlands Choice-All Plans | $23 | 726% |
| Wppa-All Plans | $23 | 726% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Smith County Memorial Hospital in Smith Center, KS, lists a cash price of $24.00, which matches the facility's gross charge and the state median. This cash rate is notably higher than the Medicare benchmark of $3.17, reflecting the typical administrative markup found in commercial billing structures. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and Medicaid/KanCare range from $10 to $24, patients with high-deductible plans may find the cash price more favorable if their insurance allows a higher allowed amount than 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 fee reductions can significantly lower the final cost for those paying out-of-pocket.
The facility's negotiated rates vary by payer, with the lowest allowed amount being $10 from Blue Cross Blue Shield and the highest at $24 from Medicaid/KanCare, while the median negotiated rate across all payers is $23.00. Given that over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded bill rather than accepting a summary invoice to ensure no unbundled charges or services not rendered are included. If a balance bill arises from an out-of-network ancillary service, such as a specific lab test within an in-network facility, the No Surprises Act may provide protection against unexpected costs; in such cases, patients should dispute the bill in writing with the insurer rather than paying immediately out of fear of credit damage. Always verify your deductible status before