Blood test, cholesterol (lipid panel)
Facility: F W Huston Medical Center
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $104
- Cash Discount Price: $108
- vs. Medicare Baseline: 7.77x 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 777% of the Medicare baseline (a markup of 677%). 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 | $43 | 321% |
| Aetna | $102 | 762% |
| Humana | $107 | 799% |
| Cigna | $115 | 859% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at F W Huston Medical Center in Winchester, KS, the facility's cash price of $108.00 is notably lower than the state average of $136.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield, Aetna, Humana, and Cigna range from $102.00 to $107.00, these amounts are still higher than the cash price. This pricing structure suggests that patients with high-deductible plans or those without insurance may save money by paying the cash price directly, as the negotiated rates do not offer a discount over the self-pay amount. Additionally, the facility's median negotiated payment of $55.00 is significantly lower than the gross charge, indicating a substantial reduction from the list price, though this does not necessarily benefit the patient unless their insurance plan covers the full negotiated amount.
To ensure you are receiving the best possible rate, it is important to verify your specific plan's coverage and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling your visit. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to confirm that all ancillary services, such as laboratory tests, are covered under your plan to avoid unexpected charges. If you choose to pay out-of-pocket, you should request a formal, itemized bill to review the exact CPT codes and unit costs, as summary bills may obscure individual line items. Finally, remember that while Medicare rates serve as a benchmark for fair pricing, the most effective way to reduce costs is to compare the