Blood test, cholesterol (lipid panel)
Facility: Scott County Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $94
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 7.02x 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 702% of the Medicare baseline (a markup of 602%). 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 |
|---|---|---|
| UnitedHealthcare | $13 - $99 | 97% |
| Blue Cross Blue Shield | $43 | 321% |
| Humana | $44 | 329% |
| Wppa | $62 - $1,200 | 463% |
| Aetna | $94 | 702% |
Consumer Guidance & Cost Commentary
For this blood test at Scott County Hospital, the negotiated rates range from $13 to $1,200 depending on your specific insurance plan, with a median negotiated amount of $94. It is important to note that cash payments can sometimes be cheaper than insurance rates, particularly if you have a high-deductible plan where the insurer's allowed amount exceeds the cash price. Since the facility is a Critical Access Hospital in Scott City, KS, and the data does not provide specific county or state average comparisons for this service, patients should directly contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can significantly reduce the final bill.
The Medicare benchmark for this procedure is $13.39, which serves as a baseline for evaluating pricing fairness; commercial negotiated rates often exceed this by a significant margin due to administrative costs and contract structures. If you receive a bill that seems unexpectedly high, consider requesting an itemized billing audit to identify potential errors, such as unbundled codes or services not rendered, as over 80% of hospital bills contain inaccuracies. Additionally, if you are out-of-network, be aware that the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, so do not feel pressured to pay surprise charges immediately without first disputing the bill with your insurer.