Blood test, cholesterol (lipid panel)
Facility: Saint John Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $14
- Cash Discount Price: $13
- vs. Medicare Baseline: 1.05x 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 |
|---|---|---|
| Tricare | $13 | 97% |
| Midland Care Connection | $13 | 97% |
| Medicaid / KanCare | $13 | 97% |
| UnitedHealthcare | $13 - $19 | 97% |
| Cigna | $13 | 97% |
| Aetna | $13 - $23 | 97% |
| Medicare (plans) | $13 | 97% |
| Celtic | $14 - $58 | 105% |
| Healthy Blue | $14 | 105% |
| Kansas Superior Select | $14 | 105% |
| Employer Direct Healthcare | $19 | 142% |
| Corizon | $19 | 142% |
| Well Path | $19 | 142% |
| Centurion | $20 | 149% |
| Naphcare | $21 | 157% |
| Blue Cross Blue Shield | $21 - $43 | 157% |
| Comp Alliance Workers Comp | $27 | 202% |
| Oha Networks | $29 | 217% |
| Worker Compensation | $30 | 224% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Saint John Hospital in Leavenworth, KS, the cash median price is $13.00, which is significantly lower than the facility's negotiated rates ranging from $13.00 to $58.00 across various payers. While the facility's cash rate is competitive, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. If you have a high-deductible plan, paying the cash price of $13.00 upfront may result in lower out-of-pocket costs compared to your insurance paying a negotiated rate that could reach $58.00, especially if your deductible has not yet been met. To maximize savings, we recommend contacting the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these programs can further reduce the final amount owed.
It is important to distinguish between the facility's gross charge of $166.00 and the actual amounts billed to patients or insurers, as the gross charge is often inflated to make discounts appear larger. The Medicare benchmark for this service is $13.39, which serves as a reliable baseline for evaluating pricing fairness, as commercial rates are frequently marked up significantly above this federal standard. If you receive a bill that includes charges higher than the cash or negotiated rates, you may be facing balance billing, particularly if certain ancillary services or specific provider lines are out-of-network. In such cases, you have the right to dispute the bill under the No Surprises Act and should request a formal, itemized audit to identify any unbundled codes or services not rendered before agreeing to