Blood test, cholesterol (lipid panel)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $14
- Cash Discount Price: $59
- 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 |
|---|---|---|
| Smarthealth | $12 - $19 | 90% |
| Humana | $13 - $14 | 97% |
| Va | $13 | 97% |
| Providrs Care | $13 | 97% |
| Medicare (plans) | $13 - $14 | 97% |
| UnitedHealthcare | $13 - $37 | 97% |
| Medicaid / KanCare | $14 | 105% |
| Aetna | $14 | 105% |
| Ambetter / Centene | $23 | 172% |
| Blue Cross Blue Shield | $65 - $198 | 485% |
Consumer Guidance & Cost Commentary
For the CPT code 80061, a blood test for a cholesterol lipid panel, Ascension Via Christi Hospital Manhattan charges a gross price of $148.00. While the facility offers a cash median price of $59.00, commercial insurance negotiated rates vary significantly, ranging from $12.00 to $198.00 depending on the payer. Notably, Blue Cross Blue Shield plans have negotiated rates as high as $198.00, which exceeds the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to verify your specific plan's negotiated amount before scheduling, as in-network rates do not always represent the lowest possible cost, and you should explicitly ask the hospital about self-pay or prompt-pay discounts to potentially lower your out-of-pocket expense.
This service is benchmarked against Medicare, which sets a fixed reimbursement rate of $13.39 for this procedure. The facility's cash price of $59.00 is approximately 4.4 times the Medicare rate, reflecting the standard markup found in commercial pricing where negotiated rates often average between 200% and 300% of the Medicare baseline. Since the data provided does not include specific state or county average figures for comparison, patients should rely on the Medicare rate as the objective cost baseline to evaluate the facility's pricing. To ensure accuracy, consumers should request a full itemized bill before payment to identify any errors or unbundled charges, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.