Blood test, cholesterol (lipid panel)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $48
- Cash Discount Price: $90
- vs. Medicare Baseline: 3.58x 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 358% of the Medicare baseline (a markup of 258%). 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 | $34 - $72 | 254% |
| Blue Cross Blue Shield | $43 | 321% |
| UnitedHealthcare | $43 - $55 | 321% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) service at Community Memorial Healthcare, Inc. in Marysville, Kansas, the facility's cash median price is $90.00, which matches the cash median reported for the state of Kansas. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates vary significantly by insurer; for example, UnitedHealthcare plans pay a median of $48.00, whereas Aetna plans pay a median of $68.00. It is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures, meaning patients with high-deductible plans might find paying the full cash price of $90.00 more cost-effective than relying on insurance, especially if their deductible has not yet been met.
When evaluating the cost relative to federal standards, the facility's Medicare amount of $13.39 serves as the objective baseline for pricing. The facility's negotiated rates are substantially higher than this benchmark, reflecting the typical markup found in commercial insurance contracts. To ensure you are receiving the best possible price, we recommend requesting a "self-pay" or "prompt-pay" discount directly from the billing department before scheduling your visit, as these upfront payment incentives can reduce the final amount owed. Additionally, if you receive an itemized bill, review it carefully to ensure no services were billed that were not rendered or included in the original test package, as over 80% of hospital bills contain errors that can be corrected through a formal audit.