Blood test, cholesterol (lipid panel)
Facility: Lane County Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $100
- Cash Discount Price: $100
- vs. Medicare Baseline: 7.47x 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 747% of the Medicare baseline (a markup of 647%). 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 | $90 - $100 | 672% |
| Aetna | $90 - $95 | 672% |
| Healthy Blue Mcr Adv - All Other Plans | $100 | 747% |
| Healthy Blue Mcaid | $100 | 747% |
| Medicaid / KanCare | $100 - $110 | 747% |
| Wppa Providers-All Plans | $150 | 1120% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Lane County Hospital in Dighton, Kansas, the cash median price is $100.00, which matches the facility's negotiated rate for UnitedHealthcare, Aetna, and Healthy Blue plans. This cash price is notably lower than the Medicare benchmark of $13.39 when adjusted for the 7.5% variance factor provided in the dataset, highlighting that commercial rates often reflect administrative overhead and contract dynamics rather than pure service cost. While Medicaid/KanCare plans show a range of $100 to $110, patients with high-deductible plans may find paying the $100 cash price directly more advantageous than relying on insurance, as the negotiated rates for many commercial payers can exceed the cash amount, potentially leading to higher out-of-pocket costs if deductibles are not yet met.
Patients should be aware that while the facility is a Critical Access Hospital owned by a Government Hospital District, the final amount owed can vary based on billing practices and contract terms. It is crucial to request a prompt-pay discount before scheduling, as paying in full upfront can often reduce the bill by 20% to 50% by bypassing costly insurance claims processing. Additionally, if a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they may face balance billing for the difference between the provider's chargemaster rate and the insurance allowed amount; however, the No Surprises Act protects patients from these surprise bills for emergency and non-emergency services at in-network facilities. To ensure accuracy, patients should always demand a full itemized bill rather than accepting a summary invoice, as over 80%