Blood test, cholesterol (lipid panel)
Facility: Ashland Health Center
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $60
- Cash Discount Price: $49
- vs. Medicare Baseline: 4.48x 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 448% of the Medicare baseline (a markup of 348%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $20 - $21 | 149% |
| Compalliance-All Plans | $48 - $50 | 358% |
| Health Partners Of Kansas-All Plans | $51 - $53 | 381% |
| Multiplan-All Plans | $59 - $61 | 441% |
| Healthy Blue Mcr Adv - All Other Plans | $60 - $62 | 448% |
| UnitedHealthcare | $60 - $62 | 448% |
| Medicare (plans) | $60 - $62 | 448% |
| Health Choice-All Plans | $60 - $62 | 448% |
| Medica Mcare - All Plans | $60 - $62 | 448% |
| Medicaid / KanCare | $60 - $62 | 448% |
| Aetna | $60 - $62 | 448% |
| Providers Care (Wppa)-All Plans | $90 - $93 | 672% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Ashland Health Center in Ashland, KS, the facility's cash median rate is $49.00, while the median negotiated rate across 12 payers is $60.00. This indicates that paying out-of-pocket directly can be more cost-effective than using insurance for this specific service, as the cash price is lower than the average amount insurers negotiate. The facility's cash rate is also notably lower than the gross charge of $61.00, reflecting standard billing practices where upfront payment avoids administrative overhead. Patients with high-deductible plans may find it financially advantageous to pay the cash price of $49.00 rather than relying on insurance, which would result in a higher allowed amount of $60.00 or more depending on the specific plan.
The facility's negotiated rates range from $20.00 to $93.00 depending on the insurance carrier, with the lowest negotiated rate of $20.00 belonging to Blue Cross Blue Shield and the highest at $93.00 for Providers Care (Wppa)-All Plans. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, there is no rating data available for this location. To secure the best possible price, patients should explicitly request a self-pay or prompt-pay discount before scheduling, as these discounts can reduce the final bill by 20% to 50% if paid in full upfront. It is important to verify the exact allowed amount with the insurance provider before the visit, as the negotiated rate varies significantly by payer and could exceed the cash price, making out-of-pocket payment the