Blood test, cholesterol (lipid panel)
Facility: Overland Park Reg Med Ctr
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $84
- Cash Discount Price: $477
- vs. Medicare Baseline: 6.27x 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 627% of the Medicare baseline (a markup of 527%). 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 |
|---|---|---|
| Cigna | $7 - $14 | 52% |
| United | $12 - $225 | 90% |
| Blue Cross Blue Shield | $13 - $215 | 97% |
| Humana | $13 - $33 | 97% |
| Coventry | $13 - $201 | 97% |
| Devoted Health | $13 | 97% |
| Home State Health Plan | $13 | 97% |
| Amerigroup | $13 | 97% |
| Aetna | $13 - $255 | 97% |
| Triwest Health Alliance | $14 | 105% |
| Pyramid Life | $14 | 105% |
| Celtic | $14 | 105% |
| Medicaid / KanCare | $14 | 105% |
| Wellcare | $14 | 105% |
| Unicare | $14 | 105% |
| Healthyblue | $14 | 105% |
| Oscar | $20 | 149% |
| Multiplan | $24 - $370 | 179% |
| Corvel Corporation | $28 - $325 | 209% |
| Oha Network | $30 - $250 | 224% |
| Ambetter / Centene | $84 - $93 | 627% |
| Nhc Advantage | $86 - $95 | 642% |
| Wppa Providrs Care Network | $91 - $100 | 680% |
| Universal Healthcare | $159 - $175 | 1187% |
| Coventry Kc Mo | $186 - $205 | 1389% |
| College Park Family Care Center | $195 - $215 | 1456% |
| Focus Healthcare Mgmt, Inc | $340 - $375 | 2539% |
| Cco, Inc. | $340 - $375 | 2539% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Overland Park Reg Med Ctr, the cash price is $477.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average of $13.39 for this service, reflecting the facility's proprietary ownership and location in Overland Park, KS. While commercial payers negotiate rates that range from $7 to $375 depending on the plan, many of these negotiated amounts exceed the cash price. For patients with high-deductible plans, paying the cash price of $477.00 upfront may be more cost-effective than relying on insurance, as the insurer's allowed amount could be higher than the cash rate. Patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can reduce the final bill by 20% to 50%.
It is important to distinguish between the facility's gross charges and the actual costs covered by insurance. The facility's gross charge for this code is $477.00, but commercial payers have negotiated a ceiling that varies widely, with some plans paying as low as $7 and others up to $375. The median negotiated rate across all payers is $84.00, which is substantially lower than the cash price, though individual plan allowances may differ. When reviewing your bill, ensure you receive an itemized statement rather than a summary bill, as hospitals may obscure individual line items to hide errors or unbundled charges. If you receive a bill that does not match the allowed amount or includes services not