Blood test, cholesterol (lipid panel)
Facility: Lmh
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $14
- Cash Discount Price: $8
- vs. Medicare Baseline: 1.05x 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.
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 |
|---|---|---|
| Cigna | $5 - $356 | 37% |
| Blue Cross Blue Shield | $6 - $230 | 45% |
| Aetna | $7 - $296 | 52% |
| Non Contracted | $7 - $285 | 52% |
| Humana | $8 - $356 | 60% |
| UnitedHealthcare | $8 - $362 | 60% |
| Medicare (plans) | $8 - $356 | 60% |
| First Health | $8 - $331 | 60% |
| Ambetter / Centene | $8 - $21 | 60% |
| Haskell Indian Health Services | $8 - $13 | 60% |
| Allwell | $9 - $14 | 67% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) service at Lmh in Lawrence, KS, the facility's cash median price is $8.00, which is significantly lower than the Medicare benchmark of $13.39. While the facility is a government-owned acute care hospital, the negotiated rates for commercial payers range widely, with the lowest allowed amount being $5.00 for Cigna plans and the highest reaching $362.00 for UnitedHealthcare. This disparity highlights that in-network coverage does not guarantee the lowest price, as some commercial contracts exceed the cash-pay rate. Patients with high-deductible plans may find it financially advantageous to pay the $8.00 cash price directly, provided they have not yet met their deductible, rather than relying on insurance that could result in higher out-of-pocket costs due to administrative markups.
To secure the best possible rate, patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% when paid upfront. It is crucial to request a waiver of insurance submission before check-in to prevent the hospital from automatically billing the insurance carrier, which would void any cash discount agreement. Additionally, since over 80% of hospital bills contain errors, patients should always request a detailed, itemized statement rather than accepting a summary bill, ensuring they can identify any unbundled codes or services not rendered. By comparing the facility's cash rate against the Medicare benchmark and actively negotiating, consumers can avoid unexpected balance billing and ensure they are paying a fair price for this essential laboratory service.