CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Valley County Health System

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $35
Cash Discount Price: $92
vs. Medicare Baseline: 2.61x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Valley County Health System is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.61x the Medicare baseline. Located in 2707 L Street, Ord, NE.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$13.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13.39 (100%)

Cash / Self-Pay: $92 (687%)

Insurance Median: $35 (261%)

Cash: $92 (687% of Medicare)

Ins. Median: $35 (261% of 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 261% of the Medicare baseline (a markup of 161%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

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	$8 - $159	60%
Great Plains	$8 - $33	60%
Humana	$8 - $34	60%
Medica	$8 - $159	60%
UnitedHealthcare	$8 - $80	60%
Molina	$14 - $87	105%
Nebraska Total Care	$14 - $91	105%
Wellcare	$21 - $91	157%
Aetna	$37 - $159	276%
Multiplan/Phcs	$38 - $163	284%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $92.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80061.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Valley County Health System is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80061.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.