Blood test, cholesterol (lipid panel)
Facility: St. Catherine Hospital - Garden City
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $51
- Cash Discount Price: $127
- vs. Medicare Baseline: 3.81x 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 381% of the Medicare baseline (a markup of 281%). 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 |
|---|---|---|
| Devoted Health | $13 | 97% |
| Innovage | $13 | 97% |
| Medicare (plans) | $13 | 97% |
| UnitedHealthcare | $13 - $90 | 97% |
| Kansas Health | $13 | 97% |
| Kaiser | $13 - $135 | 97% |
| Humana | $13 | 97% |
| Blue Cross Blue Shield | $13 - $51 | 97% |
| Aetna | $13 - $122 | 97% |
| Cigna | $13 - $17 | 97% |
| Centura Employee Plan | $17 | 127% |
| United Colorado Doctor'S Plan | $20 | 149% |
| Direct To Employer | $23 - $196 | 172% |
| Wpaa | $102 | 762% |
| Denver Health | $116 | 866% |
| Christian Health Aid | $116 | 866% |
| Multiplan | $131 - $417 | 978% |
| Health Partners Of Kansas | $141 | 1053% |
| Peak Health | $191 | 1426% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at St. Catherine Hospital in Garden City, Kansas, the cash median price is $127.00, which is significantly lower than the facility's gross charge of $318.00. While many commercial payers have negotiated rates ranging from $13 to $196, the cash price remains the most transparent baseline for patients. It is important to note that for individuals with high-deductible plans, paying the cash price of $127.00 upfront can sometimes be more cost-effective than relying on insurance, particularly if the negotiated rate exceeds the cash amount or if the patient has not yet met their deductible. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
The facility's pricing is evaluated against a Medicare benchmark of $13.39, which serves as the objective baseline for healthcare costs in this region. Although the Medicare amount is the lowest figure in the dataset, commercial negotiated rates vary widely, with some plans like Multiplan reaching up to $417.00 and others, such as Devoted Health and Innovage, settling at $13.00. This disparity highlights that in-network status does not guarantee the lowest price, as administrative structures and contract dynamics can inflate costs. To ensure accuracy, patients should request an itemized billing audit to verify that all charges align with the allowed amounts and that no unbundled codes or services not rendered are included in the final invoice.