Blood test, cholesterol (lipid panel)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $61
- Cash Discount Price: $45
- vs. Medicare Baseline: 4.56x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 456% of the Medicare baseline (a markup of 356%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Healthcare Highways [2210] | $61 | 456% |
| Web Tpa [2115] | $61 | 456% |
| Aetna | $61 | 456% |
| Blue Cross Blue Shield | $61 | 456% |
| Hooray Health [8000] | $61 | 456% |
| Lucent Health [6000] | $61 | 456% |
| Oncology Patient Assistance Programs [2295] | $61 | 456% |
| Black Lung [6055] | $61 | 456% |
| Department Of Corrections [1340] | $74 | 553% |
| American Postal Workers Union [1070] | $86 | 642% |
| National Association Of Letter Carriers [1695] | $86 | 642% |
| Cigna | $86 | 642% |
| Healthpartners [1500] | $86 | 642% |
| Humana | $88 | 657% |
| Multiplan [1680] | $115 | 859% |
| Administrative Concepts [1005] | $115 | 859% |
| American Healthcare [1055] | $115 | 859% |
| First Health [1375] | $115 | 859% |
| Coventry Healthcare [1320] | $122 | 911% |
| Ks Disability Determination [6090] | $149 | 1113% |
Consumer Guidance & Cost Commentary
For this blood test service at the University of Kansas Health System - St Francis Campus, the negotiated rate of $61.00 is significantly lower than the facility's gross charge of $149.00, reflecting the standard contractually agreed-upon pricing with commercial payers. While this negotiated amount is higher than the cash median of $45.00, patients with high-deductible plans may find paying the cash price directly more cost-effective, as the insurance negotiated rate often exceeds the cash price due to administrative overhead. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying cash upfront. Additionally, patients should explicitly ask the facility about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can further reduce the final bill by bypassing the costly insurance claims processing cycle.
The facility's pricing is benchmarked against the federal Medicare rate of $13.39, which serves as the objective baseline for evaluating hospital markups. In this case, the commercial negotiated rate of $61.00 represents a substantial markup compared to the Medicare amount, illustrating how commercial contracts often inflate baseline prices to cover administrative structures. To ensure you are receiving fair pricing, it is recommended to compare these rates against state or county averages where available, rather than relying on the hospital's full chargemaster list which can be inflated. If you receive a bill that includes charges for services not rendered or unbundled codes, you should request a formal itemized billing audit to identify errors and dispute any discrepancies in writing, as over 80% of hospital bills contain mistakes