Blood test, cholesterol (lipid panel)
Facility: Nemaha Valley Community Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $9
- Cash Discount Price: $14
- vs. Medicare Baseline: 0.67x 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.
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 |
|---|---|---|
| Va Ccn - All Plans | $2 - $15 | 15% |
| Aetna | $4 - $95 | 30% |
| Humana | $4 - $49 | 30% |
| Celtic Comm Exch - All Plans | $5 - $54 | 37% |
| Partners Direct Health - All Plans | $5 - $58 | 37% |
| Multiplan - All Plans | $8 - $101 | 60% |
| Health Partners - All Plans | $9 - $106 | 67% |
| Midlands Choice - All Plans | $9 - $106 | 67% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash median price is $14.00, which is lower than the negotiated rates paid by most insurance plans. While the facility's negotiated rate averages $9.00, commercial payers like Aetna and Multiplan have allowed amounts ranging from $4 to $106, indicating that insurance reimbursement varies significantly by plan. Patients with high-deductible plans may find paying the $14.00 cash price upfront more cost-effective than relying on insurance, as the negotiated rates for many carriers exceed the cash amount. Additionally, Nemaha Valley Community Hospital offers a prompt-pay discount for those who settle their bill in full within 30 days, which can further reduce the final cost.
When comparing this facility's pricing to broader benchmarks, the cash price of $14.00 is slightly higher than the Medicare amount of $13.39, reflecting the standard markup for commercial services. The facility's negotiated rate of $9.00 is notably lower than the gross charge of $15.00, demonstrating the impact of insurance contracts on final patient costs. However, because the gross charge is significantly higher than the Medicare rate, patients should avoid using the chargemaster list as a benchmark for savings. To ensure the lowest possible cost, patients are encouraged to request an itemized billing audit before payment to verify that no unbundled codes or services not rendered are included in the final invoice.