Blood test, cholesterol (lipid panel)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $126
- Cash Discount Price: $112
- vs. Medicare Baseline: 9.41x 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 941% of the Medicare baseline (a markup of 841%). 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 - $43 | 306% |
| UnitedHealthcare | $126 - $140 | 941% |
| Providers Care (Wppa)-All Plans | $245 | 1830% |
Consumer Guidance & Cost Commentary
For the cholesterol lipid panel procedure at Hospital District #6 Patterson Health Center in Anthony, KS, the cash median price is $112.00, which is lower than the facility's negotiated rates of $126.00 and the highest commercial payer rates ranging from $126.00 to $140.00. While the facility's cash price is also lower than the gross charge of $140.00, it is important to note that commercial insurance contracts often result in higher out-of-pocket costs for patients with high deductibles, as the negotiated rates can exceed the cash price. Medicare serves as the benchmark for this service, with a reimbursement rate of $13.39, indicating that the cash price of $112.00 represents a significant markup over the federal baseline. Patients should verify their specific plan details, as paying cash upfront may be more cost-effective than relying on insurance if their deductible has not yet been met.
To minimize unexpected costs, consumers should request a prompt-pay discount before scheduling the test, which can reduce the bill by 20% to 50% if paid in full within 30 days. If you choose to use insurance, be aware that balance billing could occur if out-of-network services are provided, though the No Surprises Act protects patients from such charges for emergency care and non-emergency services at in-network facilities. Always demand an itemized bill before paying to ensure no errors, double-billing, or unbundled codes are present, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.