Blood test, cholesterol (lipid panel)
Facility: Susan B Allen Memorial Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $554
- Cash Discount Price: $53
- vs. Medicare Baseline: 41.37x 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 4137% of the Medicare baseline (a markup of 4037%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 2614% |
| Providrs Care | $757 | 5653% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $53.00, which is significantly lower than the facility's negotiated rates of $554.00 and the state average of $53.00. While UnitedHealthcare and Providrs Care have negotiated rates of $350 and $757 respectively, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds this figure. It is important to note that while the facility is a voluntary non-profit acute care hospital, the cash rate of $53.00 represents a potential savings compared to the full chargemaster gross of $81.00, though patients should verify if their specific plan covers this service to avoid unexpected out-of-pocket costs.
Patients should be aware that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40% above the true cost of care, making the Medicare benchmark of $13.39 a useful reference point for understanding fair pricing. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to request a self-pay or prompt-pay discount before scheduling, as waiting until after receiving a bill may void these agreements. To ensure accuracy, consumers should demand an itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered, which can be disputed in writing to reduce medical debt.