81015

Urinalysis using microscope

Medicare pricing data for 3,090 providers across 48 states

🤖AI Overview

This procedure has a 6.2x markup — hospitals charge $18.34 but Medicare allows only $2.98. Uninsured patients may face bills 6.2 times higher than what insurance negotiates. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Urinalysis using microscope (HCPCS code 81015) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $2.98, but hospitals typically charge $18.34 — a 6.2x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$0.60

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $2.98, your out-of-pocket cost would be approximately $0.60. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$2.98
Average Hospital Charge
$18.34
Markup Ratio
6.2x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$18.34
Medicare Allowed$2.98
Medicare Payment$2.98

Hospitals charge 6.2x more than what Medicare allows for this procedure. Medicare actually pays $2.98 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Maryland$3$13196,504+0.7%
Florida$3$2014518,281+0.3%
Kansas$3$29464,384+0.3%
Louisiana$3$816876+0.3%
Maine$3$123266+0.3%
Massachusetts$3$241027,730+0.3%
Missouri$3$15821,313+0.3%
Montana$3$1318156+0.3%
Nebraska$3$1314182+0.3%
Nevada$3$2691,528+0.3%
New Hampshire$3$1021103+0.3%
New Jersey$3$2787,460+0.3%
New Mexico$3$2116150+0.3%
New York$3$151134,954+0.3%
Ohio$3$22902,490+0.3%
Pennsylvania$3$21342,893+0.3%
Rhode Island$3$105178+0.3%
South Carolina$3$1580858+0.3%
Tennessee$3$22682,256+0.3%
Texas$3$2210610,374+0.3%
Utah$3$972621+0.3%
Wyoming$3$92130+0.3%
Alaska$3$391231+0.3%
Arizona$3$13225,773+0.3%
California$3$1816716,176+0.3%
Connecticut$3$25214+0.3%
Hawaii$3$1141,5450.0%
Idaho$3$14261650.0%
Illinois$3$16427,3250.0%
Indiana$3$21416500.0%
North Dakota$3$2392170.0%
Oklahoma$3$12233,2320.0%
Oregon$3$111373,8830.0%
South Dakota$3$16292090.0%
Virginia$3$111304,4940.0%
Wisconsin$3$261951,4850.0%
Alabama$3$12491,8740.0%
Arkansas$3$10571,0030.0%
Iowa$3$1657271-0.3%
Kentucky$3$8301,218-0.3%
Mississippi$3$1370562-0.3%
North Carolina$3$182569,387-0.3%
Washington$3$18862,471-0.3%
Georgia$3$181619,356-0.7%
Minnesota$3$172931,081-0.7%
Colorado$3$15181,469-0.7%
West Virginia$3$23730-1.0%
Michigan$3$1945449-1.7%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber