CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Mercy Hospital - Cassville

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $58
Cash Discount Price: $47
vs. Medicare Baseline: 18.30x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Mercy Hospital - Cassville is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 18.30x the Medicare baseline. Located in 94 Main Street, Cassville, MO.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$58

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$3.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $3.17 (100%)

Cash / Self-Pay: $47 (1483%)

Insurance Median: $58 (1830%)

Cash: $47 (1483% of Medicare)

Ins. Median: $58 (1830% of 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 1830% of the Medicare baseline (a markup of 1730%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$3 - $65	95%
Blue Cross Blue Shield	$3 - $71	95%
Humana	$3 - $62	95%
Medicaid / KanCare	$3 - $38	95%
Medicare (plans)	$3 - $31	95%
UnitedHealthcare	$4 - $69	126%
Dept Of Veteran Affairs Contracted [320106]	$25	789%
Cherokee Nation Health Serv Contracted [320066]	$30	946%
Cigna	$30 - $69	946%
Cross Timbers Hospice [20098]	$30	946%
Elara Caring Aspire Hospice [20433]	$30	946%
Globalhealth Contracted [320145]	$30	946%
Halo Hcr Inc Hospice Contracted [320432]	$30	946%
Halo Hcr Inc Hospice [20432]	$30	946%
Indian Health Service Contracted [320198]	$30	946%
Kindful Hospice Contracted [320434]	$30	946%
Kindful Hospice [20434]	$30	946%
Medical Associates Health Contracted [320444]	$30	946%
Mercy Hospice Okc [20252]	$30	946%
Mercy Mgd Behavioral Health Contracted [320259]	$30	946%
Pace Of The Ozarks Contracted [320518]	$30	946%
Provider Partners Health Plans Contracted [320450]	$30	946%
Qual Choice Contracted [320325]	$30	946%
Tricare	$30	946%
Healthscope Contracted [320182]	$31	978%
Administrative Payor Contracted [320005]	$33	1041%
Centivo Contracted [320505]	$37	1167%
Ambetter / Centene	$38	1199%
Home State Health Plan Contracted [320187]	$38	1199%
Novasys Contracted [320285]	$38	1199%
Healthlink Contracted [320179]	$47 - $66	1483%
Preferred Health Plan Contracted [320522]	$47	1483%
Health Systems Inc Contracted [320174]	$58	1830%
Insurance System Inc Contracted [320465]	$58	1830%
Point C Contracted [320238]	$58 - $66	1830%
Point C [20238]	$58	1830%
United Medical Resources Contracted [320454]	$58 - $62	1830%
Workers Comp [20426]	$58 - $66	1830%
Municipal Health Plan Contracted [320271]	$59	1861%
Medica Contracted [320239]	$65	2050%
90 Degree Benefits Contracted [320436]	$66	2082%
Aither Health Contracted [320449]	$66	2082%
American Healthcare Alliance Contracted [320020]	$66	2082%
Auxiant Contracted [320462]	$66	2082%
Benefit Management Contracted [320052]	$66	2082%
Ebms Contracted [320493]	$66	2082%
Edison Health Solutions Contracted [320502]	$66	2082%
Evolutions Health Care Contracted [320124]	$66	2082%
Imagine 360 Contracted [320494]	$66	2082%
Mercy Benefit Admin Contracted [320251]	$66	2082%
Reflect Health Contracted [320492]	$66	2082%
Show-Me Health Administrators Contracted [320483]	$66	2082%
Usa Managed Care Org Contracted [320429]	$66	2082%
Yuzu Health Contracted [320521]	$66	2082%
First Health Contracted [320128]	$69	2177%
Multiplan Contracted [320270]	$69	2177%
Private Health Care Systems Contracted [320320]	$69	2177%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $47.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 81001.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital - Cassville is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 81001.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.