Blood test, cholesterol (lipid panel)
Facility: Great Plains Of Sabetha
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $55
- Cash Discount Price: $59
- vs. Medicare Baseline: 4.11x 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 411% of the Medicare baseline (a markup of 311%). 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 |
|---|---|---|
| Celtic Mcr Adv | $29 - $33 | 217% |
| Aetna | $29 - $64 | 217% |
| Celtic Comm Exchange-All Other Plans | $36 - $41 | 269% |
| Great West Healthcare-All Plans | $47 - $54 | 351% |
| UnitedHealthcare | $51 - $63 | 381% |
| Multiplan-Phcs-All Plans | $52 - $60 | 388% |
| Century/Wppa/Providers-All Plans | $52 - $60 | 388% |
| Cigna | $52 - $60 | 388% |
| Humana | $52 - $60 | 388% |
| Federated Mutual Ins-All Plans | $53 - $60 | 396% |
| Blue Cross Blue Shield | $55 - $63 | 411% |
| Medicaid / KanCare | $55 - $63 | 411% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Great Plains Of Sabetha, the cash price is $59.00, which matches the facility's median negotiated rate. This cash price is significantly higher than the Medicare benchmark of $13.39, reflecting the standard markup for commercial services. While the facility is a Critical Access Hospital in Sabetha, KS, the data does not provide specific county or state average comparisons for this code type. However, patients should note that commercial insurance plans often negotiate rates higher than cash prices due to administrative costs and contract structures; for instance, the median negotiated rate across payers is $55.00, while individual plan ranges vary from $29 to $64. If a patient has a high-deductible plan, paying the cash price of $59.00 upfront may result in lower out-of-pocket costs compared to the insurance allowed amount, which could exceed the cash rate depending on the specific plan's negotiated tier.
To ensure you are not overcharged, it is essential to request a full itemized bill before finalizing payment, as summary bills often obscure individual line items and potential errors. Since over 80% of hospital bills contain mistakes, such as unbundled codes or charges for services not rendered, a detailed review is the most effective way to reduce medical debt. Additionally, patients should verify if the facility offers "prompt-pay" discounts, which can reduce the total cost by 20% to 50% for upfront payments, effectively bypassing the administrative overhead of insurance claims processing. If you receive a balance bill from an out-of-network provider, even at an in-network facility, you may have protections