Blood test, cholesterol (lipid panel)
Facility: Lindsborg Community Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $165
- Cash Discount Price: $126
- vs. Medicare Baseline: 12.32x 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 1232% of the Medicare baseline (a markup of 1132%). 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 | $43 | 321% |
| Tricare | $85 | 635% |
| Coventry Mcr Adv | $86 | 642% |
| Cigna | $153 | 1143% |
| UnitedHealthcare | $162 | 1210% |
| Coventry Comm-All Other Plans | $162 | 1210% |
| Multiplan-All Plans | $168 | 1255% |
| Phcs Preferred-All Plans | $168 | 1255% |
| Health Partners -All Plans | $171 | 1277% |
| Wppa-All Plans | $171 | 1277% |
| Coventry Wc | $171 | 1277% |
| Century Health-All Plans | $171 | 1277% |
Consumer Guidance & Cost Commentary
For this blood test, cholesterol (lipid panel) procedure at Lindsborg Community Hospital, the cash payment rate of $126 is significantly lower than the facility's gross charge of $181 and sits well below the state of Kansas average, which is $12.39 higher than the cash price. While the facility is a voluntary non-profit critical access hospital, patients should note that the insurance negotiated rate averages $165, which is higher than the cash price. This pricing structure suggests that for patients with high-deductible plans or those seeking to minimize out-of-pocket costs, paying the cash rate directly may be more advantageous than relying on insurance, provided they can secure the lower cash or self-pay classification before services begin.
The facility offers a median negotiated rate of $165 across 12 payers, with the highest rates observed from Health Partners, Wppa, and Coventry West at $171, and the lowest from Blue Cross Blue Shield and Tricare at $43. Although the median paid amount is $168, which is slightly higher than the negotiated rate, patients are encouraged to explicitly request "prompt-pay" discounts or self-pay rates prior to scheduling to bypass the administrative overhead of claims processing. Additionally, since federal protections under the No Surprises Act ban balance billing for out-of-network services at in-network facilities, patients should verify that all ancillary services, such as lab work, are properly classified to avoid unexpected charges.