CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Ellinwood District Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $47
  • Cash Discount Price: $57
  • vs. Medicare Baseline: 3.51x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Ellinwood District Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.51x the Medicare baseline. Located in 605 N Main Street, Ellinwood, KS.
Cash / Self-Pay
$57

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$13.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13.39 (100%)
Cash / Self-Pay: $57 (426%)
Insurance Median: $47 (351%)
Cash: $57 (426% of Medicare)
Ins. Median: $47 (351% of 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 351% of the Medicare baseline (a markup of 251%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $47 351%
Cigna $47 351%
Humana $47 351%
Blue Cross Blue Shield $47 351%
Aetna $47 351%

Consumer Guidance & Cost Commentary

For the blood test, cholesterol (lipid panel) procedure at Ellinwood District Hospital in Kansas, the cash median price is $57.00, while the median negotiated rate across five payers is $47.00. This facility, a Critical Access Hospital owned by the Government - Hospital District or Authority, shows a negotiated rate that is 30% lower than its gross charge of $67.00. When comparing these rates to the broader market, the facility's cash price of $57.00 is notably higher than the state average for this service, which sits at $47.00. However, for patients with high-deductible plans, paying the cash price of $57.00 upfront could be more cost-effective than relying on insurance, as the negotiated rate of $47.00 often exceeds the cash price due to administrative overheads included in commercial contracts.

Patients should be aware that hospitals often issue summary bills that obscure individual line items, making it difficult to identify errors or unbundled charges. To protect against overcharging, consumers should request a full itemized CPT-coded bill before paying, ensuring that services like the lipid panel are charged at the correct unit cost rather than broad categories. Additionally, since this facility offers a cash price of $57.00, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full within a short window can sometimes reduce the final amount. It is also important to verify your deductible status before using insurance, as paying the negotiated rate of $47.00 may not cover your costs if your plan has not yet met its deductible threshold.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 605 N Main Street, Ellinwood, KS 67526
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals