Blood test, cholesterol (lipid panel)
Facility: Sheridan County Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $59
- Cash Discount Price: $88
- vs. Medicare Baseline: 4.41x 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 441% of the Medicare baseline (a markup of 341%). 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 Insurance | $53 | 396% |
| Blue Cross Blue Shield | $59 | 441% |
| UnitedHealthcare | $84 | 627% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Sheridan County Hospital in Hoxie, KS, the cash price is $88.00, which matches the facility's cash median. This rate is significantly higher than the state average, as indicated by a 4.4x markup compared to Medicare reimbursement. While commercial insurance carriers like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare have negotiated rates of $53.00 and $59.00 respectively, these amounts may not be the lowest option for every patient. If you have a high-deductible plan or have not yet met your deductible, paying the $88.00 cash price directly could result in immediate savings compared to the insurance negotiated rates, which often include administrative overheads that inflate the baseline cost.
Patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. It is important to remember that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur if ancillary services are not properly covered. To ensure accuracy, request a full itemized CPT-coded bill before making any payments, as summary bills often obscure individual line items. Given that over 80% of hospital bills contain errors, verifying the exact charges for the lipid panel code 80061 is essential to avoid double-billing or unbundled fees that could increase your total cost.