Urinalysis (automated, with microscopy)
Facility: Oakleaf Surgical Hospital
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $3
- Cash Discount Price: $16
- vs. Medicare Baseline: 0.95x 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $3 | 95% |
| Dean Health Plan | $3 | 95% |
| Group Health Cooperative Of Eau Claire | $3 | 95% |
| Healthpartners | $3 | 95% |
| Humana | $3 | 95% |
| Medica | $3 | 95% |
| Quartz Health Solutions | $3 | 95% |
| Security Health Plan Of Wi | $3 | 95% |
| Ucare Wi | $3 | 95% |
| UnitedHealthcare | $3 | 95% |
Consumer Guidance & Cost Commentary
For patients paying cash directly, the most important thing to know is that paying upfront can often be cheaper than using insurance, especially if your plan has a high deductible or if the insurance negotiated rate exceeds the cash price. For this urinalysis procedure at Oakleaf Surgical Hospital in Altoona, WI, the cash median rate is $16, which is notably lower than the facility's gross charge of $18. While the hospital is a Physician-owned Acute Care Hospital, there is no specific cash discount percentage listed in the data, so you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling your visit to ensure you receive the lowest possible rate.
When looking at broader rate context, the facility's cash median of $16 is significantly lower than the gross charge of $18, but it is important to note that the median negotiated rate is $3, which is lower than the cash price. This suggests that while cash payment avoids the administrative overhead of insurance claims, the contracted rates with insurance carriers in this specific instance are already below the cash benchmark. Additionally, the facility's pricing aligns closely with the Medicare amount of $3.17, which serves as a federal cost baseline; commercial rates often run higher, but in this case, the negotiated rate is the lowest figure provided. With 10 payers participating in this program, patients with in-network coverage may find their out-of-pocket costs lower than the cash option, provided their plan covers the service and their deductible has been met.