Blood test, cholesterol (lipid panel)
Facility: Stanton County Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $135
- Cash Discount Price: $102
- vs. Medicare Baseline: 10.08x 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 1008% of the Medicare baseline (a markup of 908%). 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 | $41 - $230 | 306% |
| Healthy Blue Mcr Adv - All Other Plans | $134 - $238 | 1001% |
| Healthy Blue Mcaid | $136 - $207 | 1016% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Stanton County Hospital in Johnson, KS, the cash price is $102.00, which matches the facility's median paid amount. This cash rate is significantly lower than the negotiated rates charged to insurance plans, with Blue Cross Blue Shield paying a median of $132.00 and Healthy Blue plans paying between $134.00 and $138.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find that paying the $102.00 cash price upfront is more cost-effective than relying on insurance, as the negotiated rates exceed the cash amount. It is important to note that while the facility is in-network for these payers, the administrative costs associated with processing claims often result in higher allowed amounts compared to direct payment.
Patients should be aware that commercial insurance rates for this service are benchmarked against Medicare, which sets the baseline reimbursement at $13.39. The negotiated rates paid by insurers are substantially higher than this federal standard, reflecting the complex administrative structures and contract dynamics between providers and payers. To minimize costs, consumers should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these programs can offer further reductions for upfront payments. Additionally, if a patient receives a bill that includes charges for out-of-network ancillary services, they may be entitled to protections under the No Surprises Act, which prevents balance billing for emergency or non-emergency care at in-network facilities.