Blood test, cholesterol (lipid panel)
Facility: Wilson Medical Center
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $36
- Cash Discount Price: $30
- vs. Medicare Baseline: 2.69x 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 269% of the Medicare baseline (a markup of 169%). 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 |
|---|---|---|
| Ambetter / Centene | $6 - $68 | 45% |
| Humana | $6 - $36 | 45% |
| Aetna | $6 - $68 | 45% |
| UnitedHealthcare | $6 - $63 | 45% |
| Tricare | $6 - $36 | 45% |
| Cigna | $10 - $54 | 75% |
| Mulitplan-All Plans | $11 - $63 | 82% |
| Health Partners-All Plans | $11 - $63 | 82% |
| Blue Cross Blue Shield | $12 - $68 | 90% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) service at Wilson Medical Center in Neodesha, KS, the facility's cash median rate is $30.00, while the median negotiated rate for in-network payers is $36.00. This data reflects a scenario where paying out-of-pocket directly may be more cost-effective than using insurance, as the cash price is lower than the average amount insurers negotiate. Patients with high-deductible plans should consider paying the cash price of $30.00 upfront, as this avoids the administrative overhead and markup inherent in the insurance billing cycle. It is important to verify with the hospital whether "self-pay" or "prompt-pay" discounts are available, as these programs can further reduce the final amount owed by bypassing the standard claims processing fees that often inflate commercial rates.
The facility's pricing is benchmarked against federal standards, with the Medicare amount for this code set at $13.39. While the specific county or state average is not provided in this dataset, the Medicare rate serves as a critical baseline for understanding the facility's markup; commercial negotiated rates often exceed Medicare benchmarks by significant margins due to administrative costs and contract dynamics. If a patient receives this service out-of-network, they must be aware of the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services at in-network facilities. To ensure transparency and avoid unexpected charges, patients should request a full itemized bill before paying, as summary invoices can obscure individual line items and potential errors. Disputing any discrepancies in writing is the most effective way to hold the facility accountable for accurate pricing.