Blood test, cholesterol (lipid panel)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $22
- Cash Discount Price: $112
- vs. Medicare Baseline: 1.64x 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 $13.39 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 |
|---|---|---|
| UnitedHealthcare | $12 - $116 | 90% |
| Aetna | $12 - $146 | 90% |
| Humana | $12 - $13 | 90% |
| Medicaid / KanCare | $12 - $23 | 90% |
| Tricare | $13 | 97% |
| Kindful Hospice Contracted [320434] | $13 | 97% |
| Dept Of Veteran Affairs Contracted [320106] | $13 | 97% |
| Elara Caring Aspire Hospice [20433] | $13 | 97% |
| Blue Cross Blue Shield | $13 - $52 | 97% |
| Pace Of The Ozarks Contracted [320518] | $13 | 97% |
| Halo Hcr Inc Hospice [20432] | $13 | 97% |
| Mercy Hospice Okc [20252] | $13 | 97% |
| Halo Hcr Inc Hospice Contracted [320432] | $13 | 97% |
| Kindful Hospice [20434] | $13 | 97% |
| Medicare (plans) | $13 | 97% |
| Cross Timbers Hospice [20098] | $13 | 97% |
| Medica Contracted [320239] | $13 | 97% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $14 | 105% |
| Health Choice Contracted [320166] | $18 | 134% |
| Home State Health Plan Contracted [320187] | $23 | 172% |
| Ambetter / Centene | $23 | 172% |
| Providrs Care Network Contracted [320484] | $25 | 187% |
| Cigna | $111 - $114 | 829% |
| United Medical Resources Contracted [320454] | $116 | 866% |
| Yuzu Health Contracted [320521] | $138 | 1031% |
| Auxiant Contracted [320462] | $138 | 1031% |
| Reflect Health Contracted [320492] | $138 | 1031% |
| Healthlink Contracted [320179] | $138 | 1031% |
| American Healthcare Alliance Contracted [320020] | $138 | 1031% |
| Edison Health Solutions Contracted [320502] | $138 | 1031% |
| Workers Comp [20426] | $138 | 1031% |
| Aither Health Contracted [320449] | $138 | 1031% |
| Mercy Benefit Admin Contracted [320251] | $138 | 1031% |
| Imagine 360 Contracted [320494] | $138 | 1031% |
| Ebms Contracted [320493] | $138 | 1031% |
| First Health Contracted [320128] | $146 | 1090% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Mercy Hospital Pittsburg, Inc, the facility's cash price of $112.00 is significantly lower than the negotiated rates paid by most insurance plans, which range from $12 to $146 depending on the carrier. While the facility's cash rate is higher than the state average of $112.00, it remains substantially below the highest negotiated rates observed, such as $146 for First Health Contracted. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance negotiated rates often exceed the cash amount, potentially resulting in higher out-of-pocket costs if the patient's deductible has not yet been met.
To avoid unexpected charges, patients should verify whether their specific insurance plan is in-network and request a prompt-pay discount before scheduling, which can reduce the bill by 20% to 50% if paid upfront. If a balance bill arises from an out-of-network service, patients should not pay immediately; instead, they should dispute the bill with their insurer and request a No Surprises Act audit to ensure compliance with federal protections. Finally, patients should always demand a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute sent to the billing supervisor.