Blood test, cholesterol (lipid panel)
Facility: Girard Medical Center
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $58
- Cash Discount Price: $99
- vs. Medicare Baseline: 4.33x 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 433% of the Medicare baseline (a markup of 333%). 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 - $58 | 321% |
| Humana | $58 | 433% |
| Ambetter / Centene | $58 | 433% |
| Medicare (plans) | $58 | 433% |
| UnitedHealthcare | $58 - $157 | 433% |
| Aetna | $58 - $289 | 433% |
| Kansas Superior Select-All Plans | $58 | 433% |
| Multiplan-All Plans | $153 | 1143% |
| Uhhis-All Plans | $157 | 1173% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Girard Medical Center in Girard, KS, the facility's negotiated rates range from $43 to $289 depending on the insurance plan, with a median negotiated amount of $58. This facility is a Critical Access Hospital owned by a Government Hospital District, and its pricing is significantly higher than the state average, which is represented by a 4.3x markup relative to Medicare. While the facility offers a cash price of $99, patients with high-deductible plans may find this amount lower than their insurance negotiated rates, particularly for plans like UnitedHealthcare or Aetna where the allowed amounts can reach up to $289. It is important to verify your specific plan's allowed amount before scheduling, as assuming that being in-network guarantees the lowest possible price can lead to unexpected costs if the contract rate exceeds the cash price.
To minimize out-of-pocket expenses, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can bypass costly insurance billing cycles and administrative fees. Additionally, since over 80% of hospital bills often contain errors, consumers are encouraged to request a full itemized CPT-coded bill rather than accepting a summary invoice, which may hide unbundled charges or services not rendered. When reviewing your final statement, compare the total charges directly against the Medicare benchmark of $13.39 for this service; commercial rates are often marked up significantly above this federal baseline, and understanding this true cost baseline helps identify if the negotiated or cash rates are reasonable for the care provided.