Blood test, cholesterol (lipid panel)
Facility: Clara Barton Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $118
- Cash Discount Price: $92
- vs. Medicare Baseline: 8.81x 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 881% of the Medicare baseline (a markup of 781%). 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% |
| 6 Degrees Health - All Plans | $92 | 687% |
| Wppa-All Plans | $105 | 784% |
| UnitedHealthcare | $118 | 881% |
| Aetna | $118 | 881% |
| Phcs - All Plans | $118 | 881% |
| Hlth Partners Of Ks-All Plans | $121 | 904% |
Consumer Guidance & Cost Commentary
For the CPT code 80061, representing a blood test for cholesterol (lipid panel), Clara Barton Hospital in Hoisington, KS, has a negotiated rate of $118.00, which is 8.8% higher than the Medicare benchmark of $13.39. While the facility offers a cash median price of $92.00, patients with high-deductible plans should consider that paying cash upfront might be more cost-effective than using insurance, as the negotiated rate often exceeds the cash price. It is important to note that the facility's negotiated rate of $118.00 is significantly higher than the lowest negotiated rate of $43.00 found among other payers in the state, highlighting the variability in pricing across different insurance networks.
To ensure you are receiving the most accurate and fair pricing, always request an itemized bill before making any payments, as summary bills can obscure individual charges and potential errors. If you choose to pay out-of-pocket, ask specifically about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if settled within a short window. Additionally, be aware that while the No Surprises Act protects you from balance billing for emergency care at in-network facilities, unexpected charges can still occur if ancillary services are provided by out-of-network providers, so verifying the network status of all services is crucial before scheduling.