Blood test, cholesterol (lipid panel)
Facility: William Newton Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $5
- Cash Discount Price: $8
- vs. Medicare Baseline: 0.37x 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.
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 |
|---|---|---|
| Providrs Care - All Other Plans | $2 - $49 | 15% |
| Providrs Care Nexus | $2 - $43 | 15% |
| Triwest- All Plans | $3 - $24 | 22% |
| Blue Cross Blue Shield | $3 - $41 | 22% |
| Ambetter / Centene | $3 - $70 | 22% |
| UnitedHealthcare | $3 - $63 | 22% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at William Newton Hospital in Winfield, KS, the cash price is $8.00, which matches the facility's cash median. This rate is significantly lower than the Medicare benchmark of $13.39, indicating a potential savings of 40% compared to the federal baseline. While the hospital is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying the $8.00 cash price more advantageous than relying on insurance, as commercial negotiated rates often exceed cash prices due to administrative overhead. It is important to note that while the facility offers a cash rate, patients should verify if their specific insurance plan has a negotiated rate that might be lower, though data shows the median negotiated amount across payers is also $5.00, suggesting the cash price is competitive.
Patients should be aware of balance billing risks if they receive care from out-of-network providers, even at an in-network facility, where the provider could bill the difference between their full chargemaster rate and the insurance allowed amount. However, the No Surprises Act protects patients from such surprise bills for emergency and non-emergency services at in-network facilities. To minimize costs, consumers are encouraged to request a self-pay or prompt-pay discount before scheduling, which can reduce the bill by 20% to 50% by bypassing claims processing fees. Additionally, if a patient receives an itemized bill, they should request a full line-by-line audit to identify any errors, double-billing, or unbundled codes, as over 80% of hospital bills contain mistakes that can be corrected through formal written disputes.