Blood test, cholesterol (lipid panel)
Facility: Cloud County Health Center
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $171
- Cash Discount Price: $126
- vs. Medicare Baseline: 12.77x 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 1277% of the Medicare baseline (a markup of 1177%). 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 |
|---|---|---|
| Aetna | $162 - $168 | 1210% |
| Mpi-All Plans | $171 | 1277% |
| Health Partners - All Plans | $171 | 1277% |
| Pponext-All Plans | $171 | 1277% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Cloud County Health Center in Concordia, KS, the facility's cash median price is $126.00, which is lower than the negotiated rates of $171.00 paid by Aetna, Mpi-All Plans, Health Partners - All Plans, and Pponext-All Plans. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients with high-deductible plans may find paying the cash price of $126.00 more beneficial than using insurance, as the negotiated rates exceed the cash amount. To maximize savings, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final cost.
When reviewing your bill, it is important to distinguish between the facility's gross charge of $181.00 and the actual amounts paid by insurers or cash payers, as the latter figures reflect the true market value for this service. Although the data does not provide specific state or county average comparisons for this code, the significant difference between the cash price and the negotiated rates highlights how administrative costs and contract dynamics can inflate commercial billing. If you receive a bill that includes charges for services not rendered or unbundled components, you have the right to request a detailed, itemized audit to identify errors before agreeing to any payment plan or settlement.