Blood test, cholesterol (lipid panel)
Facility: Grisell Memorial Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $53
- Cash Discount Price: $83
- vs. Medicare Baseline: 3.96x 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 396% of the Medicare baseline (a markup of 296%). 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 |
|---|---|---|
| UnitedHealthcare | $12 - $65 | 90% |
| Blue Cross Blue Shield | $41 | 306% |
| Humana | $88 | 657% |
| Medicaid / KanCare | $88 | 657% |
Consumer Guidance & Cost Commentary
For this cholesterol panel test at Grisell Memorial Hospital in Ransom, KS, the cash price is $83.00, which is notably lower than the facility's negotiated rates of $53.00 and the highest commercial payer rate of $88.00. While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $83.00 rate is lower than the $88.00 maximum charged by Humana and the $88.00 rate charged by Medicaid/KanCare. It is important to note that the cash price is also lower than the Medicare benchmark of $13.39 when adjusted for the facility's specific cost structure, highlighting that commercial negotiated rates often include significant administrative overhead that cash payments bypass.
To minimize costs, patients should proactively request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. Since the facility's cash rate is already competitive with the commercial negotiated rates, there is little additional savings to be gained from prompt-pay discounts on this specific service, but verifying the exact self-pay classification before check-in is essential to avoid automatic insurance claims that could void any potential cash agreement. Additionally, because this is a laboratory service, patients should ensure they are not being balance billed for out-of-network ancillary services, though the No Surprises Act generally protects against such unexpected charges for emergency or non-emergency care at in-network facilities.