Urinalysis (automated, with microscopy)
Facility: Greeley County Health Services
Billing Code: 81001 (CPT)
- CPT Billing Code: 81001
- Insurance Median: $3
- Cash Discount Price: $25
- 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 |
|---|---|---|
| Medicaid / KanCare | $3 | 95% |
| Aetna | $3 | 95% |
Consumer Guidance & Cost Commentary
For this automated urinalysis procedure at Greeley County Health Services, the cash price of $25.00 is notably lower than the facility's gross charge of $35.00 and significantly lower than the Medicare benchmark of $3.17, which serves as the federal baseline for cost. While the facility's negotiated rate with Aetna is $3.00, this figure appears to be an outlier or data anomaly given the gross charge; typically, negotiated rates are higher than cash prices due to administrative overhead, though in this specific dataset, the cash rate is the most favorable option. Patients with high-deductible plans should consider paying the $25.00 cash price directly, as it avoids potential deductibles and copays that could exceed this amount, especially if the insurance negotiated rate were to apply a higher markup.
It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details before scheduling. If you are self-paying, ask the billing department about "prompt-pay" discounts, which can further reduce the $25.00 cash rate by 20% to 50% if paid upfront. Additionally, always request a full itemized bill rather than accepting a summary invoice, as hospitals may include unbundled charges or services not rendered that could inflate the final cost. Since this facility is a Critical Access Hospital in Tribune, KS, with government ownership, the pricing structure may differ from private providers, but comparing the $25.00 cash rate against the Medicare benchmark provides a clear picture of the facility's cost efficiency relative to federal standards.