CMS Price Transparency Data

Urinalysis (automated, with microscopy)

Facility: Duncan Regional Hospital, Inc

Billing Code: 81001 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 81001
  • Insurance Median: $49
  • Cash Discount Price: $7
  • vs. Medicare Baseline: 15.46x Medicare
The contracted insurance negotiated median rate for a Urinalysis (automated, with microscopy) at Duncan Regional Hospital, Inc is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7. Compared to the federal Medicare reimbursement reference rate of $3.17, this hospital’s rate is 15.46x the Medicare baseline. Located in 1407 Whisenant Drive, Duncan, OK.
Cash / Self-Pay
$7

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $7 (221%)
Insurance Median: $49 (1546%)
Cash: $7 (221% of Medicare)
Ins. Median: $49 (1546% 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 1546% of the Medicare baseline (a markup of 1446%). 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.

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
Medica $2 63%
Humana $3 95%
Friday Health Plan $9 284%
Blue Cross Blue Shield $12 379%
Healthcare Highways $33 - $49 1041%
UnitedHealthcare $52 1640%
Oklahoma Health Network (Ohn) $61 1924%
Aetna $65 2050%
Coventry $65 2050%
Cigna $68 2145%
First Health $68 2145%
Osma Health $68 2145%
Preferred Community Choice $70 2208%
Healthsmart $71 2240%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1407 Whisenant Drive, Duncan, OK 73533
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals