Blood test, cholesterol (lipid panel)
Facility: Logan County Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $103
- Cash Discount Price: $30
- vs. Medicare Baseline: 7.69x 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 769% of the Medicare baseline (a markup of 669%). 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% |
| Humana | $64 | 478% |
| Health Partners - All Plans | $142 | 1060% |
| Medicaid / KanCare | $150 | 1120% |
Consumer Guidance & Cost Commentary
For this cholesterol blood test at Logan County Hospital in Oakley, Kansas, the negotiated rate for in-network insurance is $103, while the cash-pay price is significantly lower at $30. This cash rate is notably cheaper than the facility's negotiated rate, illustrating that paying out-of-pocket can sometimes be the most cost-effective option for patients with high-deductible plans or those without insurance. Since the facility is a Critical Access Hospital owned by the local government, patients should proactively ask about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not charged the full insurance negotiated amount.
It is important to understand that the $103 rate represents the maximum amount an insurance plan like Blue Cross Blue Shield or Humana will pay, not necessarily the final bill you receive. If your plan has a high deductible, you may still owe the difference between your deductible and the $103 allowed amount, whereas paying the $30 cash price upfront avoids this potential gap. Additionally, because Medicare rates for this service are only $13.39, the commercial negotiated rate of $103 reflects standard administrative costs and contract dynamics rather than a markup on the true cost of care.