Blood test, cholesterol (lipid panel)
Facility: Norton County Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $60
- Cash Discount Price: $104
- vs. Medicare Baseline: 4.48x 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 448% of the Medicare baseline (a markup of 348%). 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 | $60 | 448% |
Consumer Guidance & Cost Commentary
For this cholesterol blood test at Norton County Hospital in Norton, KS, the facility's negotiated rate of $60.00 is significantly lower than the state average of $149.00, reflecting the impact of local contract dynamics. While the facility's gross charge is $149.00, patients with high-deductible plans may find the cash price of $104.00 more advantageous than the insurance negotiated rate, as administrative overhead often inflates commercial rates by 20% to 40% above the true cost. It is important to note that the Medicare benchmark for this service is $13.39, which serves as the objective baseline for evaluating fair pricing; commercial rates typically range from 200% to 300% of this amount, whereas fair pricing is generally defined as 120% to 150% of the Medicare rate.
To minimize out-of-pocket costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can bypass costly claims processing and administrative fees. Since over 80% of hospital bills contain errors, patients should demand a full itemized CPT-coded statement rather than accepting a summary bill, ensuring no unbundled codes or services not rendered are included. Additionally, because the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients can confidently dispute any unexpected charges without fear of credit damage. Always verify your deductible status prior to using insurance, as paying the full negotiated rate without meeting your deductible balance can result in higher costs than paying the cash price directly.