Blood test, cholesterol (lipid panel)
Facility: Pratt Regional Medical Center
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $57
- Cash Discount Price: $46
- vs. Medicare Baseline: 4.26x 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 426% of the Medicare baseline (a markup of 326%). 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 |
|---|---|---|
| Christian Health Aid | $26 - $68 | 194% |
| UnitedHealthcare | $28 - $92 | 209% |
| Health Partners Of Kansas | $29 - $77 | 217% |
| Aetna | $31 - $81 | 232% |
| Choicecare | $34 - $90 | 254% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) service at Pratt Regional Medical Center in Pratt, KS, the facility's cash median price is $46.00, which is lower than the negotiated rates paid by major insurers like UnitedHealthcare and Aetna. While the facility's negotiated rates range from $26 to $92 depending on the payer, the cash price offers a potential savings for patients with high-deductible plans who may not yet have met their coverage thresholds. It is important to note that commercial insurance rates often include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40% compared to direct cash payments. Patients should verify their specific plan's deductible status before scheduling, as paying out-of-pocket at the cash rate may result in immediate savings if the insurer's allowed amount exceeds $46.00.
The facility's pricing is evaluated against a Medicare benchmark of $13.39, showing a markup of 4.3 times the Medicare rate, which aligns with the typical commercial range of 200% to 300% of Medicare. Although state or county average data was not provided in this report, patients are encouraged to request a detailed, itemized bill to ensure no errors exist, as over 80% of hospital bills contain mistakes such as double-billing or unbundled codes. To maximize savings, individuals should inquire about "self-pay" or "prompt-pay" discounts before check-in, which can reduce the final balance by 20% to 50% by bypassing costly claims processing and administrative labor. Finally, if a balance bill arises from out-of-network ancillary services, patients