Blood test, cholesterol (lipid panel)
Facility: Memorial Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $99
- Cash Discount Price: $181
- vs. Medicare Baseline: 7.39x 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 739% of the Medicare baseline (a markup of 639%). 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 | $30 | 224% |
| Tricare | $90 | 672% |
| Humana | $90 | 672% |
| Medicare (plans) | $91 | 680% |
| Ambetter / Centene | $99 | 739% |
| Coventry - All Other Plans | $162 | 1210% |
| Preferred Healthcare-All Plans | $171 | 1277% |
| Health Partners Of Kansas - All Plans | $171 | 1277% |
| Wppa/Providers Care-All Plans | $253 | 1889% |
Consumer Guidance & Cost Commentary
For CPT code 80061, a blood test for cholesterol, Memorial Hospital in Abilene, KS, lists a cash price of $181.00, which matches the facility's median negotiated rate. This cash price is significantly higher than the Medicare benchmark of $13.39, reflecting a markup of 7.4 times the federal rate. While commercial payers negotiate rates ranging from $30 to $253, the cash option remains the most affordable direct payment method available. Patients with high-deductible plans may find it beneficial to pay the full $181.00 upfront rather than relying on insurance, as the negotiated rates for some plans exceed the cash price, potentially resulting in higher out-of-pocket costs after deductibles are met.
To minimize potential costs, patients should proactively request a "prompt-pay" discount from the hospital before scheduling, as paying in full within a short window can reduce the bill by 20% to 50%. It is also important to avoid accepting summary bills without reviewing the itemized statement, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be disputed in writing. While the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, verifying the specific allowed amount with the insurer prior to service is essential to ensure the patient understands their financial responsibility.