Blood test, cholesterol (lipid panel)
Facility: Centura St. Catherine-Dodge City
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $69
- Cash Discount Price: $42
- vs. Medicare Baseline: 5.15x 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 515% of the Medicare baseline (a markup of 415%). 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 |
|---|---|---|
| Humana | $13 | 97% |
| Aetna | $13 - $84 | 97% |
| Kansas Health | $13 | 97% |
| Cigna | $13 | 97% |
| Medicare (plans) | $13 | 97% |
| Kaiser | $13 | 97% |
| Blue Cross Blue Shield | $13 - $51 | 97% |
| Centura Employee Plan | $17 | 127% |
| UnitedHealthcare | $69 | 515% |
| Wpaa | $74 | 553% |
| Multiplan | $84 - $95 | 627% |
| Christian Health Aid | $84 | 627% |
| Health Partners Of Kansas | $95 | 709% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Centura St. Catherine-Dodge City, the cash median price is $42.00, which is significantly lower than the facility's median negotiated rate of $69.00. This price point is notably lower than the state average for Kansas, where the median negotiated rate is $69.00, and aligns with the county average for Dodge City. While commercial payers like Aetna and Multiplan have negotiated rates ranging from $13 to $95, patients with high-deductible plans may find paying the cash price of $42.00 more cost-effective than relying on insurance, which often results in higher allowed amounts due to administrative overhead and contract dynamics. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final bill by bypassing costly claims processing fees.
The facility's pricing for this service is also contextualized by the Medicare benchmark, which sets the baseline at $13.39. The commercial negotiated rates observed across various insurers average approximately 5.2 times the Medicare amount, reflecting the typical markup structure in the healthcare system. Since Medicare rates represent a scientifically validated cost baseline based on actual provider expenses, comparing the facility's cash price of $42.00 to the Medicare rate of $13.39 reveals a significant difference that highlights the value of direct payment options. Patients should be aware that while the facility is a Proprietary Acute Care Hospital in Dodge City, KS, the most effective way to minimize costs is to request an itemized CPT-coded bill