Blood test, cholesterol (lipid panel)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $59
- Cash Discount Price: $59
- 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 |
|---|---|---|
| Va Ccn - All Plans | $9 | 67% |
| Humana | $34 | 254% |
| Tricare | $37 | 276% |
| Aetna | $43 - $62 | 321% |
| Medicaid / KanCare | $43 - $69 | 321% |
| UnitedHealthcare | $43 - $69 | 321% |
| Ambetter / Centene | $47 | 351% |
| Blue Cross Blue Shield | $59 | 441% |
| Health Partners - All Plans | $66 | 493% |
| Healthy Blue Mcaid - All Plans | $69 | 515% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Trego County Lemke Memorial Hospital, the cash median price is $59.00, which is $14.00 lower than the facility's gross charge of $69.00. This cash rate aligns exactly with the median negotiated rate of $59.00 and matches the cash median for Wakeeney, Kansas. While the facility is a Critical Access Hospital with government-local ownership, patients should be aware that commercial insurance plans often pay significantly higher amounts than cash. For instance, Aetna, UnitedHealthcare, and Medicaid/KanCare have negotiated ranges starting at $43.00 and extending up to $69.00, meaning that for patients with high-deductible plans, paying the full cash price of $59.00 upfront could result in immediate savings compared to the insurer's allowed amount.
The facility's pricing is notably lower than the Medicare benchmark of $13.39, with the cash rate representing a substantial markup over the federal baseline. However, it is important to note that the "vs_medicare" metric of 4.4 indicates a specific comparative context relative to the facility's own billing structure rather than a direct consumer savings calculation against the national average. To maximize potential 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 bill. Additionally, since the No Surprises Act prohibits balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should verify that all ancillary services, such as laboratory tests,