Blood test, cholesterol (lipid panel)
Facility: Providence Medical Center
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $14
- Cash Discount Price: $13
- 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 | $13 | 97% |
| Tricare | $13 | 97% |
| Midland Care Connection | $13 | 97% |
| UnitedHealthcare | $13 - $22 | 97% |
| Blue Cross Blue Shield | $13 - $32 | 97% |
| Medicare (plans) | $13 | 97% |
| Aetna | $13 - $23 | 97% |
| Medicaid / KanCare | $13 | 97% |
| Kansas Superior Select | $14 | 105% |
| Healthy Blue | $14 | 105% |
| Celtic | $14 - $21 | 105% |
| Corizon | $17 | 127% |
| Well Path Prison | $19 | 142% |
| Employer Direct Healthcare | $19 | 142% |
| Centurion | $20 | 149% |
| Naphcare | $21 | 157% |
| Comp Alliance - Fka Compresults Worker Compensation | $27 | 202% |
| Oha Networks | $29 | 217% |
| Worker Compensation | $30 | 224% |
Consumer Guidance & Cost Commentary
For this blood cholesterol test at Providence Medical Center in Kansas City, KS, the facility's cash median rate of $13.00 is significantly lower than the state average of $36.00, making it a cost-effective option for those without insurance. While the facility's negotiated rates range from $13 to $32 across 19 payers, these amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find that paying the $13 cash rate upfront is more affordable than relying on insurance, which could result in higher out-of-pocket costs if the deductible has not yet been met. To maximize savings, it is advisable to explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these programs can offer additional reductions by bypassing standard insurance billing cycles.
The facility's pricing aligns closely with federal benchmarks, as the Medicare amount of $13.39 is nearly identical to the cash rate, indicating a transparent and fair pricing model that avoids the typical commercial markup seen in many hospitals. This proximity to the Medicare baseline suggests the facility is charging near the true cost of service delivery rather than inflating prices for administrative reasons. However, patients should remain vigilant regarding balance billing, particularly for ancillary services like lab work, which may be billed separately even at an in-network facility. If a bill exceeds the expected amount, consumers should request a full itemized audit to identify any unbundled codes or services not rendered, ensuring they are only paying for the actual care received.