Blood test, cholesterol (lipid panel)
Facility: St Luke Hospital & Living Center
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $53
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.96x 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 396% of the Medicare baseline (a markup of 296%). 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 |
|---|---|---|
| Humana | $53 | 396% |
| Bluestem Pace | $53 | 396% |
| Blue Cross Blue Shield | $53 | 396% |
| UnitedHealthcare | $53 | 396% |
| Kansas Department Of Health And Environment | $53 | 396% |
| Va Ccn | $53 | 396% |
| Ambetter / Centene | $53 | 396% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) service at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate of $53.00 aligns exactly with the lowest and highest reported rates across all seven payers, including Humana, Blue Cross Blue Shield, and UnitedHealthcare. This consistent $53.00 figure represents the standard amount commercial insurers are contractually obligated to pay for this procedure at this location. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not provide a specific cash or median paid amount for this service, so patients cannot yet determine if paying out-of-pocket directly would result in a lower cost.
To understand the true cost relative to federal standards, it is important to compare these rates against the Medicare benchmark. The Medicare amount for this code is $13.39, and the facility's negotiated rate is 400% higher than this federal baseline. This significant markup is typical for commercial contracts, which often range from 200% to 300% above Medicare rates due to administrative overhead and network tiering. Since no cash price is listed in the current data, patients should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can sometimes reduce the final bill by 20% to 50% if paid upfront. Additionally, because the facility is in-network, the No Surprises Act generally protects patients from balance billing for this service, ensuring they are only responsible for their deductible, copay, or coinsurance based on the $53.00 allowed amount.