Blood test, cholesterol (lipid panel)
Facility: Greenwood County Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $144
- Cash Discount Price: $136
- vs. Medicare Baseline: 10.75x 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 1075% of the Medicare baseline (a markup of 975%). 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 |
|---|---|---|
| UnitedHealthcare | $23 - $143 | 172% |
| Blue Cross Blue Shield | $41 - $43 | 306% |
| Triwest - All Plans | $61 | 456% |
| Tricare | $71 | 530% |
| Choicecare Mcr Adv - All Plans | $71 | 530% |
| Integrated Health Plan - All Plans | $128 | 956% |
| First Health - All Other Plans | $144 | 1075% |
| First Health Ccn Network | $144 | 1075% |
| Beech Street - All Plans | $144 | 1075% |
| Preferred Hs (Coventry) - All Plans | $153 | 1143% |
| Principal Health Care Inc - All Plans | $162 | 1210% |
| Medicaid / KanCare | $170 | 1270% |
| Amerigroup Mcaid-All Plans | $170 | 1270% |
| Providrs Care/Wppa - All Plans | $255 | 1904% |
Consumer Guidance & Cost Commentary
For this blood test service at Greenwood County Hospital in Eureka, Kansas, the cash price is $136, which is lower than the facility's negotiated rates of $144 and the state average of $144. While commercial insurance plans like UnitedHealthcare and Blue Cross Blue Shield negotiate rates ranging from $23 to $143, patients with high-deductible plans may find paying the cash price of $136 more cost-effective if their insurance allowed amount exceeds this figure. Because 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, as these upfront fee reductions can further lower the final cost compared to standard billing cycles.
It is important to note that commercial negotiated rates often include administrative overhead and do not reflect the true cost of care, which is better represented by the Medicare benchmark of $13.39. Although the facility's cash rate is significantly higher than the Medicare amount, comparing it directly to the gross charge of $170 would be misleading; the most accurate baseline for evaluating pricing fairness is the Medicare rate. If you receive a bill that includes unexpected charges beyond the negotiated or cash price, you should request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through formal written disputes.