Urinalysis (automated, with microscopy)
Facility: William Newton Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $22
- Cash Discount Price: $53
- vs. Medicare Baseline: 6.94x 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 694% of the Medicare baseline (a markup of 594%). 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 | $1 - $55 | 32% |
| Blue Cross Blue Shield | $9 - $22 | 284% |
| Triwest- All Plans | $16 - $21 | 505% |
| Ambetter / Centene | $16 - $61 | 505% |
| Providrs Care Nexus | $27 - $37 | 852% |
| Providrs Care - All Other Plans | $31 - $43 | 978% |
Consumer Guidance & Cost Commentary
For the automated urinalysis with microscopy at William Newton Hospital in Winfield, Kansas, the cash median price is $53.00, which matches the facility's gross charge. This cash rate is significantly higher than the state average, as indicated by a 6.9% variance compared to Medicare benchmarks. While commercial insurance plans like UnitedHealthcare and Blue Cross Blue Shield negotiate rates ranging from $9 to $61 depending on the specific plan, these negotiated amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the $53.00 cash median directly, as this bypasses the administrative overhead and potential higher negotiated rates charged to in-network members.
To minimize costs, patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. It is important to verify the specific allowed amount for your insurance plan before scheduling, as in-network rates vary widely across the six payers listed for this service. Additionally, since over 80% of hospital bills contain errors, consumers are encouraged to request a detailed, itemized statement rather than accepting a summary bill. If any charges appear incorrect, a formal written dispute should be sent to the billing supervisor to ensure accuracy before payment.