Blood test, cholesterol (lipid panel)
Facility: Stafford County Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $89
- Cash Discount Price: $94
- vs. Medicare Baseline: 6.65x 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 665% of the Medicare baseline (a markup of 565%). 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 |
|---|---|---|
| Va Ccn-All Plans | $13 | 97% |
| UnitedHealthcare | $13 | 97% |
| Health Partners-All Plans | $89 | 665% |
| Medica Mcr- All Plans | $94 | 702% |
| Humana | $94 | 702% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Stafford County Hospital, the cash price is $94.00, which matches the facility's negotiated rate and the median paid amount. This rate is significantly higher than the Medicare benchmark of $13.39, reflecting a markup of 6.6 times the federal baseline. While the facility is a Critical Access Hospital in Stafford, Kansas, and is owned by the local government, the pricing structure suggests that commercial insurance contracts may result in higher out-of-pocket costs compared to paying cash directly. Patients with high-deductible plans might find that paying the cash price of $94.00 upfront is more cost-effective than relying on insurance, especially if their negotiated rate exceeds the cash price or if they have not yet met their deductible.
To minimize costs, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% when paid in full before or shortly after the service. It is also important to request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be disputed. Since the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should ensure their specific plan details are reviewed before scheduling to avoid unexpected charges.