CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Pawhuska Hospital, Inc

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $135
  • Cash Discount Price: $102
  • vs. Medicare Baseline: 10.08x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Pawhuska Hospital, Inc is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 10.08x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.
Cash / Self-Pay
$102

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $102 (762%)
Insurance Median: $135 (1008%)
Cash: $102 (762% of Medicare)
Ins. Median: $135 (1008% 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 1008% of the Medicare baseline (a markup of 908%). 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.

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
Healthchoice Ip/Op Only - All Plans $22 164%
UnitedHealthcare $22 - $132 164%
Community Care Comm - All Plans $33 246%
Blue Cross Blue Shield $87 - $156 650%
Aetna $97 - $184 724%
Tricare $97 - $107 724%
Wellcare Mcr Adv - All Plans $97 - $107 724%
Humana $98 - $184 732%
Healthcare Highways - All Plans $109 - $120 814%
Cigna $114 - $125 851%
Multiplan - All Plans $125 - $138 934%
Ambetter / Centene $145 - $160 1083%
Preferred Commchoice Ip/Op Only - All Plans $150 - $166 1120%
Soonerselect Mcaid - All Plans $167 - $184 1247%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1101 East 15Th Street, Pawhuska, OK 74056
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals