Blood test, cholesterol (lipid panel)
Facility: Stevens County Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $69
- Cash Discount Price: $180
- vs. Medicare Baseline: 5.15x 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 515% of the Medicare baseline (a markup of 415%). 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 |
|---|---|---|
| Aetna | $24 - $180 | 179% |
| Blue Cross Blue Shield | $41 - $43 | 306% |
| Humana | $67 | 500% |
| First Health - All Plans | $162 | 1210% |
| Wppa - All Plans | $171 | 1277% |
| Medicaid / KanCare | $180 | 1344% |
Consumer Guidance & Cost Commentary
For this blood test at Stevens County Hospital in Hugoton, Kansas, the cash price is $180, which matches the facility's maximum negotiated rate with commercial payers. While the facility's cash price aligns with the highest commercial rates, it is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. In this specific case, the cash price is identical to the gross charge, meaning there is no discount available for paying out-of-pocket without first confirming "self-pay" or "prompt-pay" options directly with the hospital. Patients with high-deductible plans should verify if paying cash upfront would result in a lower total cost compared to their insurance's allowed amount, as commercial contracts can sometimes inflate the baseline price significantly above the actual cost of care.
The Medicare benchmark for this service is $13.39, which serves as the objective baseline for evaluating pricing markup. The facility's cash price of $180 represents a substantial markup relative to this federal rate, consistent with how commercial rates often average 200% to 300% of Medicare amounts. Since the facility is a Critical Access Hospital with government local ownership, patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it does not eliminate the difference between the cash price and the insurance allowed amount if the patient chooses to use their plan. To ensure transparency, patients are encouraged to request an itemized bill before paying, as over 80% of hospital bills contain errors that can be corrected through a formal audit dispute.