Blood test, cholesterol (lipid panel)
Facility: Lincoln County Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $43
- Cash Discount Price: $89
- vs. Medicare Baseline: 3.21x 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 321% of the Medicare baseline (a markup of 221%). 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% |
Consumer Guidance & Cost Commentary
For this blood cholesterol test at Lincoln County Hospital in Lincoln, KS, the facility's negotiated rate of $43.00 is significantly lower than the state average, which is 3.2 times higher than the Medicare benchmark of $13.39. While the facility is a Critical Access Hospital owned by the local government, patients should note that cash-pay options are often more economical than insurance claims. The cash median price is $89.00, which is higher than the negotiated rate but may still be preferable for those with high-deductible plans if their insurance allowed amount exceeds the cash price. Because the facility is in-network, patients are protected from balance billing for this service, though they should verify their specific plan's allowed amount before scheduling to ensure they are not paying the full negotiated rate out of pocket.
To maximize savings, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront. These discounts bypass the administrative costs associated with insurance claims processing and are legally required to be offered uniformly to all patients. If you receive a bill after using insurance, do not pay it immediately; instead, request a full itemized audit to check for errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Always confirm your deductible status before proceeding, as paying the negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying the cash price directly.