Blood test, cholesterol (lipid panel)
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $27
- Cash Discount Price: $140
- vs. Medicare Baseline: 2.02x 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 202% of the Medicare baseline (a markup of 102%). 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 |
|---|---|---|
| United Medical Resources Contracted [320454] | $11 - $37 | 82% |
| UnitedHealthcare | $11 - $199 | 82% |
| Blue Cross Blue Shield | $12 - $31 | 90% |
| Aetna | $12 - $13 | 90% |
| Medicaid / KanCare | $12 - $18 | 90% |
| First Health Contracted [320128] | $12 | 90% |
| Humana | $12 - $13 | 90% |
| Medicare (plans) | $13 | 97% |
| Globalhealth Contracted [320145] | $13 | 97% |
| Medica Contracted [320239] | $13 | 97% |
| Medical Associates Health Contracted [320444] | $13 | 97% |
| Mercy Hospice Okc [20252] | $13 | 97% |
| Kindful Hospice Contracted [320434] | $13 | 97% |
| Halo Hcr Inc Hospice Contracted [320432] | $13 | 97% |
| Halo Hcr Inc Hospice [20432] | $13 | 97% |
| Pace Of The Ozarks Contracted [320518] | $13 | 97% |
| Cherokee Nation Health Serv Contracted [320066] | $13 | 97% |
| Dept Of Veteran Affairs Contracted [320106] | $13 | 97% |
| Qual Choice Contracted [320325] | $13 | 97% |
| Tricare | $13 | 97% |
| Cross Timbers Hospice [20098] | $13 | 97% |
| Cigna | $13 - $114 | 97% |
| Kindful Hospice [20434] | $13 | 97% |
| Elara Caring Aspire Hospice [20433] | $13 | 97% |
| Mercy Mgd Behavioral Health Contracted [320259] | $13 | 97% |
| Provider Partners Health Plans Contracted [320450] | $14 | 105% |
| Centivo Contracted [320505] | $22 | 164% |
| Providrs Care Network Contracted [320484] | $25 | 187% |
| Point C Contracted [320238] | $37 - $161 | 276% |
| Health Systems Inc Contracted [320174] | $37 | 276% |
| Benefit Management Contracted [320052] | $37 | 276% |
| Healthscope Contracted [320182] | $37 - $161 | 276% |
| Insurance System Inc Contracted [320465] | $37 | 276% |
| Mercy Benefit Admin Contracted [320251] | $82 - $150 | 612% |
| Show-Me Health Administrators Contracted [320483] | $82 | 612% |
| Ebms Contracted [320493] | $150 | 1120% |
| Aither Health Contracted [320449] | $150 | 1120% |
| Imagine 360 Contracted [320494] | $150 | 1120% |
| Reflect Health Contracted [320492] | $150 | 1120% |
| American Healthcare Alliance Contracted [320020] | $150 | 1120% |
| Yuzu Health Contracted [320521] | $150 | 1120% |
| Auxiant Contracted [320462] | $150 - $161 | 1120% |
| Edison Health Solutions Contracted [320502] | $150 | 1120% |
| Federal Medical Center Contracted [320127] | $161 | 1202% |
| Healthlink Contracted [320179] | $161 | 1202% |
| Preferred Health Plan Contracted [320522] | $161 | 1202% |
| Compcare Of The Ozarks Contracted [320437] | $170 | 1270% |
| Workers Comp [20426] | $172 | 1285% |
| Private Health Care Systems Contracted [320320] | $199 | 1486% |
| Multiplan [20270] | $204 | 1524% |
| Multiplan Contracted [320270] | $204 | 1524% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Mercy Specialty Hospital Southeast Kansas, the facility's cash median price of $140.00 is significantly lower than the negotiated rates paid by most major payers, which range from $29.00 to $199.00. While the facility's cash rate is higher than the national Medicare benchmark of $13.39, it remains substantially below the gross charges of $215.00 and the high-end negotiated rates seen with some commercial plans. Patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $140.00, as paying out-of-pocket could result in immediate savings compared to the administrative costs and potential deductibles associated with insurance billing.
To ensure you receive the most accurate and lowest possible rate, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the $140.00 cash median. If you are billed by an out-of-network provider for services rendered at this in-network facility, you may be entitled to protections under the No Surprises Act, which prohibits balance billing for emergency and non-emergency services. Furthermore, if you receive a summary bill, you should request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies that can be resolved to lower your final cost.