Blood test, cholesterol (lipid panel)
Facility: Kansas Heart Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $13
- Cash Discount Price: $45
- vs. Medicare Baseline: 0.97x 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 |
|---|---|---|
| Aetna | $10 | 75% |
| Tricare | $12 | 90% |
| Humana | $13 | 97% |
| Celtic Mcr Adv | $13 | 97% |
| UnitedHealthcare | $13 | 97% |
| Medicaid / KanCare | $13 | 97% |
| Wppa - All Plans | $28 | 209% |
| Blue Cross Blue Shield | $29 | 217% |
| Multiplan - All Plans | $64 | 478% |
Consumer Guidance & Cost Commentary
For the CPT code 80061, representing a blood test for cholesterol (lipid panel), Kansas Heart Hospital in Wichita, KS, has a gross charge of $71.00. While the facility's cash median rate is $45.00 and the median negotiated rate across payers is $13.00, the Medicare benchmark for this service is $13.39. This indicates that the facility's cash price is significantly higher than the Medicare baseline, which serves as the objective cost standard for healthcare delivery. Commercial negotiated rates, which average between 200% and 300% of Medicare, often exceed cash prices due to the administrative overhead and contract structures required for insurance billing. Patients with high-deductible plans may find the cash price of $45.00 more affordable than the negotiated rate of $13.00 if their insurance deductible has not yet been met, as paying the cash price upfront can bypass the administrative costs and potential underpayment issues associated with insurance claims.
To maximize savings, patients should verify if the hospital offers prompt-pay discounts, which can reduce bills by 20% to 50% for upfront payment, effectively lowering the cost below the cash median. It is crucial to request self-pay classification and prompt-pay rates before check-in and sign a waiver of insurance submission to ensure the cash discount applies. Additionally, patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though unexpected charges can still occur if ancillary services are out-of-network. Since over 80% of hospital bills contain errors, consumers are encouraged to request