Blood test, cholesterol (lipid panel)
Facility: Bob Wilson Memorial Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $119
- Cash Discount Price: $58
- vs. Medicare Baseline: 8.89x 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 889% of the Medicare baseline (a markup of 789%). 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 |
|---|---|---|
| Centura Employee Plan | $17 | 127% |
| Humana | $47 | 351% |
| Medicare (plans) | $47 | 351% |
| Kansas Health | $47 | 351% |
| UnitedHealthcare | $47 - $121 | 351% |
| Aetna | $47 - $116 | 351% |
| Blue Cross Blue Shield | $58 | 433% |
| Multiplan | $131 - $135 | 978% |
| Health Partners Of Kansas | $137 | 1023% |
| Wppa | $138 | 1031% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Bob Wilson Memorial Hospital in Ulysses, Kansas, the cash median price is $58.00, which is lower than the facility's negotiated rates ranging from $47 to $138 across ten payers. While Medicare reimburses $13.39 for this service, commercial insurance contracts result in significantly higher allowed amounts, with UnitedHealthcare and Aetna allowing up to $121 and $116 respectively. Because cash prices are often lower than commercial negotiated rates, patients with high-deductible plans may save money by paying out-of-pocket, provided they verify that their specific plan does not cover the service or has a high deductible that exceeds the cash price.
To minimize unexpected costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final bill. It is also important to request a full itemized CPT-coded bill rather than accepting a summary invoice, as hospitals may bundle charges or include services not rendered, leading to errors that can be disputed in writing. Finally, while balance billing is generally prohibited for emergency services at in-network facilities under the No Surprises Act, patients should remain vigilant against summary bills that obscure individual line items and ensure all charges are transparent before payment.