Urinalysis at CHI Health Good Samaritan. CPT 81001.
What CHI Health Good Samaritan publishes for this service, straight from its standard-charges file, last updated February 28, 2026.
Outpatient / ER
$45.75cash price (self-pay)
$79.50list price
$3.07–$78.12range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Amerigroup | Medicaid|All Plans | $3.07 |
| Centene | Medicaid|IA Total Care | $3.07 |
| IAMolina | Medicaid|All Plans | $3.13 |
| BCBS - NE | Medicare|All Plans | $3.17 |
| Humana | Medicare|All Plans | $3.17 |
| Medica | Medicare|All Plans | $3.17 |
| PACE | Medicare|All Plans | $3.17 |
| United | Medicare|All Plans | $3.17 |
| Centene | Medicare|All Plans | $3.27 |
| Amerigroup | Medicare|All Plans | $3.33 |
| Great Plains | Medicare|All Plans | $3.33 |
| Medica | Commercial|ACO | $6.30 |
| Medica | Commercial|CHI Health | $6.52 |
| Medica | Commercial|All Other Plans | $6.83 |
| AMPS | Commercial|All Plans | $7.04 |
| United | Medicaid|Community Plan | $16.70 |
| Centene | Medicaid|NE Total Care | $16.87 |
| Greater Omaha Packing | Commercial|Narrow Network | $31.76 |
| Millard Public Schools | Commercial|Narrow Network | $31.76 |
| One World | Commercial|Narrow Network | $31.76 |
| Greater Omaha Packing | Commercial|Broad Network | $36.52 |
| Millard Public Schools | Commercial|Broad Network | $36.52 |
| One World | Commercial|Broad Network | $36.52 |
| Timpte | Commercial|Broad Network | $36.52 |
| Creighton University Employees | Commercial|All Plans | $38.95 |
| ELAP | Commercial|All Plans | $46.11 |
| United | Commercial|All Plans | $60.42 |
| Medica | Commercial|Open Access | $62.01 |
| Midlands Choice | Commercial|Premier | $62.01 |
| Midlands Choice | Commercial|Standard | $73.14 |
Inpatient
$45.75cash price (self-pay)
$79.50list price
$36.75–$78.12range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Creighton University Employees | Commercial|All Plans | $38.95 |
| United | Commercial|All Plans | $60.42 |
| Medica | Commercial|Open Access | $62.01 |
| Midlands Choice | Commercial|Premier | $62.01 |
| Midlands Choice | Commercial|Standard | $73.14 |
| MultiPlan PHCS | Commercial|All Plans | $73.94 |
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