Blood test, cholesterol (lipid panel)
Facility: Nmc Health
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $99
- Cash Discount Price: $106
- vs. Medicare Baseline: 7.39x 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 739% of the Medicare baseline (a markup of 639%). 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 |
|---|---|---|
| Aetna | $42 - $125 | 314% |
| Blue Cross Blue Shield | $43 | 321% |
| Wppa | $84 | 627% |
| Occunet | $91 | 680% |
| Samaritan Ministries International | $99 | 739% |
| Medincrease Health Plan | $99 | 739% |
| Prime Health Services | $114 | 851% |
| UnitedHealthcare | $137 | 1023% |
| Cigna | $144 | 1075% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) at Nmc Health in Newton, KS, the facility's cash median price of $106.00 is notably lower than the state average, which is 7.4% higher. While commercial insurance carriers negotiate rates that typically range from $42 to $144 depending on the plan, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price of $106.00 directly, as this avoids the higher negotiated rates that insurance carriers charge, provided the patient has not yet met their deductible.
To secure the lowest possible cost, consumers should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payment. It is also important to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected. When comparing prices, focus on the Medicare benchmark of $13.39 as the true cost baseline rather than the hospital's gross charges; commercial rates are often significantly higher than this federal standard, making the cash price of $106.00 a more transparent and potentially economical option for self-pay patients.