Blood test, cholesterol (lipid panel)
Facility: Kiowa County Memorial Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $105
- Cash Discount Price: $100
- vs. Medicare Baseline: 7.84x 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 784% of the Medicare baseline (a markup of 684%). 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 - $105 | 321% |
| UnitedHealthcare | $95 - $118 | 709% |
| Health Partners Of Ks-All Plans | $104 | 777% |
| Celtic Comml Exchange-All Other Plans | $105 | 784% |
| Humana | $105 | 784% |
| Aetna | $105 | 784% |
| Medica Prime Mcare Cost-All Plans | $105 | 784% |
| Medicaid / KanCare | $118 | 881% |
| Providrs Care/Wppa-All Plans | $177 | 1322% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Kiowa County Memorial Hospital in Greensburg, KS, the facility's cash median price is $100.00, which is lower than the negotiated rates paid by most insurance plans. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find that paying the cash price upfront is more cost-effective than relying on insurance, as the negotiated rates for payers like Blue Cross Blue Shield and UnitedHealthcare range from $43 to $118. It is important to note that insurance billing often includes administrative overhead and claim processing costs that can inflate the final allowed amount, making the direct cash price a potentially better option for those without significant out-of-pocket coverage.
To minimize unexpected costs, patients should actively request a "prompt-pay" discount before scheduling their visit, as paying the bill in full within 30 days can reduce the amount owed by up to 50%. Additionally, because the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should verify that all ancillary services, such as lab work, are covered under their plan to avoid surprise charges. If a discrepancy arises, consumers are advised to demand a full itemized bill showing specific CPT codes rather than accepting a summary invoice, and to dispute any errors in writing to ensure accurate billing.