Blood test, cholesterol (lipid panel)
Facility: Golden Valley Memorial Hospital
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $13
- Cash Discount Price: $133
- vs. Medicare Baseline: 0.97x 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 |
|---|---|---|
| Aetna | $13 | 97% |
| Home State Health | $13 | 97% |
| Humana | $13 | 97% |
| UnitedHealthcare | $13 - $23 | 97% |
| Ambetter / Centene | $16 | 119% |
Consumer Guidance & Cost Commentary
For this cholesterol panel test at Golden Valley Memorial Hospital, the cash median price is exactly $133. This rate is significantly lower than the facility's gross chargemaster of $222, offering a direct discount for self-pay patients. While the facility is an Acute Care Hospital in Clinton, Missouri, with a government ownership structure, the cash rate stands as the primary benchmark for patients without insurance coverage.
Insurance payers including Aetna, Home State Health, Humana, UnitedHealthcare, and Ambetter / Centene have negotiated rates of $13, which is notably lower than the cash price. However, for individuals with high-deductible plans who have not yet met their out-of-pocket maximum, paying the $133 cash rate may result in immediate savings compared to the $13 allowed amount that insurance would pay before the deductible is met. Consumers should verify their specific plan status and explicitly ask the facility about self-pay or prompt-pay discounts before scheduling to ensure they are not being billed the full negotiated rate.