Blood test, cholesterol (lipid panel)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $13
- Cash Discount Price: $98
- 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 |
|---|---|---|
| UnitedHealthcare | $13 - $16 | 97% |
| Blue Cross Blue Shield | $13 | 97% |
| United Mine Workers Of America | $13 | 97% |
| Humana | $13 | 97% |
| Providrs Care Network | $13 | 97% |
| Aetna | $13 - $17 | 97% |
| Lantern Specialty Care | $21 | 157% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Kansas Spine & Specialty Hospital, Llc in Wichita, KS, the cash median price is $98.00, which is lower than the facility's gross charge of $151.00. While the facility is owned by physicians and located in an Acute Care Hospital setting, the data does not provide specific county or state average benchmarks for this service to compare against. Patients with high-deductible plans may find the cash price more advantageous than the negotiated rates, as commercial payers like UnitedHealthcare, Aetna, and Blue Cross Blue Shield have negotiated amounts ranging from $13.00 to $21.00, which are significantly below the cash price. However, these lower negotiated rates are often subject to deductibles and copays, meaning the patient's out-of-pocket cost could still exceed the $98.00 cash price if their plan has not yet met its deductible threshold.
To minimize potential costs, patients should verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill. It is also important to be aware of balance billing protections; under the No Surprises Act, patients are generally protected from being billed for out-of-network services at in-network facilities, though unexpected charges can still occur for ancillary services if not properly reviewed. If a bill is received, consumers should request a full itemized CPT-coded statement rather than accepting a summary invoice, as detailed audits can reveal errors such as unbundled codes or services not rendered. Since over 80% of hospital bills contain errors,