Blood test, cholesterol (lipid panel)
Facility: Kansas Medical Center Llc
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $13
- Cash Discount Price: $41
- 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 |
|---|---|---|
| United | $7 | 52% |
| Indian Health | $12 | 90% |
| Blue Cross Blue Shield | $13 - $26 | 97% |
| Ambetter / Centene | $13 | 97% |
| Humana | $13 | 97% |
| Medadv_Wellcare | $13 | 97% |
| Medicaid / KanCare | $13 | 97% |
| Tricare | $13 | 97% |
| Wppa | $27 - $40 | 202% |
| Three_Rivers | $27 | 202% |
| Aetna | $42 | 314% |
Consumer Guidance & Cost Commentary
For the CPT code 80061, representing a blood test for a cholesterol lipid panel, the cash median price at Kansas Medical Center Llc in Andover, KS is $41.00. This cash rate is significantly lower than the facility's median negotiated rate of $70.00, which reflects the administrative costs and contract structures associated with insurance billing. While the facility's negotiated rates are higher than the cash price, patients with high-deductible plans may find it financially advantageous to pay the $41.00 cash rate directly, as the insurance negotiated amount often exceeds the cash price. To maximize savings, patients should verify their specific plan's deductible status and explicitly request self-pay or prompt-pay discounts before scheduling the service, as these upfront payment incentives can bypass the standard insurance billing cycle.
The facility's pricing is benchmarked against the federal Medicare rate of $13.39 for this procedure, which serves as an objective baseline for evaluating cost markup. Although the data does not provide specific state or county average figures for comparison, the Medicare rate highlights that the cash price of $41.00 represents a markup over the government's calculated cost basis. Patients should be aware that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40% compared to the true cost of care. If a patient receives a bill that appears to include balance billing or unexpected charges, they should request a full itemized audit to identify any unbundled codes or services not rendered, ensuring they are only responsible for the agreed-upon negotiated or cash rate.