CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Mercy Hospital Lincoln

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 81001
Insurance Median: $28
Cash Discount Price: $38
vs. Medicare Baseline: 8.83x Medicare

The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Mercy Hospital Lincoln is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 8.83x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.

Cash / Self-Pay

$38

Average discount available for prompt cash payment at this facility.

Insurance Median

$28

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: $38 (1199%)

Insurance Median: $28 (883%)

Cash: $38 (1199% of Medicare)

Ins. Median: $28 (883% 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 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.

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
United Medical Resources Contracted [320454]	$3	95%
UnitedHealthcare	$3 - $14	95%
Blue Cross Blue Shield	$4 - $28	126%
Cigna	$4 - $15	126%
Healthlink Contracted [320179]	$4 - $49	126%
Medicaid / KanCare	$4 - $27	126%
Aetna	$9 - $38	284%
Tricare	$12	379%
Medicare (plans)	$13 - $58	410%
American Health Advantage Of Mo Mcr [10473]	$14	442%
Cherokee Nation Health Serv Contracted [320066]	$14	442%
Cross Timbers Hospice [20098]	$14	442%
Dept Of Veteran Affairs Contracted [320106]	$14	442%
Elara Caring Aspire Hospice Contracted [320433]	$14	442%
Elara Caring Aspire Hospice [20433]	$14	442%
Globalhealth Contracted [320145]	$14	442%
Halo Hcr Inc Hospice Contracted [320432]	$14	442%
Halo Hcr Inc Hospice [20432]	$14	442%
Humana	$14 - $52	442%
Indian Health Service Contracted [320198]	$14	442%
Kindful Hospice Contracted [320434]	$14	442%
Kindful Hospice [20434]	$14	442%
Mercy Hospice Okc [20252]	$14	442%
Pace Of The Ozarks Contracted [320518]	$14	442%
Provider Partners Health Plans Contracted [320450]	$14	442%
Qual Choice Contracted [320325]	$14	442%
Centivo Contracted [320505]	$21	662%
Medica Contracted [320239]	$24	757%
Ambetter / Centene	$27	852%
Home State Health Plan Contracted [320187]	$27	852%
Novasys Contracted [320285]	$27	852%
Hope Trust Contracted [320488]	$29	915%
Health Choices Contracted [320448]	$35	1104%
Health Choices [20448]	$35	1104%
Medical Associates Health Contracted [320444]	$35	1104%
First Health Contracted [320128]	$38 - $44	1199%
Mercy Mgd Behavioral Health Contracted [320259]	$44	1388%
Multiplan Contracted [320270]	$44	1388%
Private Health Care Systems Contracted [320320]	$44	1388%
Workers Comp [20426]	$44 - $46	1388%
Aither Health Contracted [320449]	$49	1546%
Aither Health [20449]	$49	1546%
Auxiant Contracted [320462]	$49	1546%
Ebms Contracted [320493]	$49	1546%
Edison Health Solutions Contracted [320502]	$49	1546%
Federal Medical Center Contracted [320127]	$49	1546%
Imagine 360 Contracted [320494]	$49	1546%
Insurance System Inc Contracted [320465]	$49	1546%
Mercy Benefit Admin Contracted [320251]	$49	1546%
Mercy Benefit Admin [20251]	$49	1546%
Point C Contracted [320238]	$49	1546%
Preferred Health Plan Contracted [320522]	$49	1546%
Reflect Health Contracted [320492]	$49	1546%
Show-Me Health Administrators Contracted [320483]	$49	1546%
Tri State Healthcare Coalition Contracted [320379]	$49	1546%
Yuzu Health Contracted [320521]	$49	1546%

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 $38.
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 Lincoln 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.