Urinalysis (automated, with microscopy)
Facility: Bob Wilson Memorial Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $35
- Cash Discount Price: $17
- vs. Medicare Baseline: 11.04x 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 1104% of the Medicare baseline (a markup of 1004%). 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 |
|---|---|---|
| Centura Employee Plan | $4 | 126% |
| Blue Cross Blue Shield | $13 | 410% |
| Medicare (plans) | $14 | 442% |
| Humana | $14 | 442% |
| UnitedHealthcare | $14 - $36 | 442% |
| Aetna | $14 - $34 | 442% |
| Kansas Health | $14 | 442% |
| Multiplan | $38 - $40 | 1199% |
| Health Partners Of Kansas | $40 | 1262% |
| Wppa | $41 | 1293% |
Consumer Guidance & Cost Commentary
For the CPT code 81001, Urinalysis (automated, with microscopy), Bob Wilson Memorial Hospital in Ulysses, KS, lists a cash median price of $17.00 and a median negotiated rate of $35.00. This cash price is significantly lower than the facility's Medicare benchmark of $3.17, which serves as the federal government's objective baseline for the true cost of this service. While commercial insurance contracts often result in negotiated rates that average 200% to 300% of Medicare, the cash price here remains well below the Medicare rate, suggesting that paying out-of-pocket may be the most cost-effective option for patients with high-deductible plans who have not yet met their coverage thresholds.
Patients should be aware that while the facility is a Critical Access Hospital with a voluntary non-profit church ownership, the specific negotiated rates vary widely among payers, ranging from $4.00 for Centura Employee Plans to $41.00 for WPPA. Because administrative overhead and contract dynamics often inflate commercial rates, it is advisable to verify your specific plan's allowed amount before scheduling. Additionally, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the costly claims processing cycle that insurance billing entails.