Blood test, cholesterol (lipid panel)
Facility: Wamego Health Center
Billing Code: 80061 (CPT)
- CPT Billing Code: 80061
- Insurance Median: $14
- Cash Discount Price: $83
- vs. Medicare Baseline: 1.05x 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 |
|---|---|---|
| UnitedHealthcare | $13 | 97% |
| Providrs Care | $13 | 97% |
| Aetna | $14 | 105% |
| Medicaid / KanCare | $14 | 105% |
| Blue Cross Blue Shield | $176 - $186 | 1314% |
Consumer Guidance & Cost Commentary
For the blood test, cholesterol (lipid panel) procedure at Wamego Health Center, the cash median price is $83.00, which is significantly lower than the facility's negotiated rates of $14.00 for Medicaid/KanCare and $13.00 to $14.00 for UnitedHealthcare, Aetna, and Providrs Care. While commercial payers like Blue Cross Blue Shield have negotiated rates ranging from $176.00 to $186.00, patients with high-deductible plans may find the cash price more affordable if their insurance allowed amount exceeds this figure. It is important to note that the facility's cash rate is substantially higher than the Medicare benchmark of $13.39, reflecting the administrative costs and profit margins inherent in commercial billing structures.
When reviewing your bill, ensure you request a full itemized statement rather than accepting a summary invoice that obscures individual charges, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you are paying out-of-pocket, ask the billing department about "prompt-pay" discounts, which can reduce the total by 20% to 50% if settled within 30 days, effectively bypassing the costly insurance claims process. Additionally, since this facility is a Critical Access Hospital in Kansas, the Medicare rate serves as a reliable baseline for evaluating fairness; commercial rates often average 200% to 300% of this federal benchmark, so comparing your specific allowed amount against the $13.39 Medicare rate provides a clearer picture of the true cost than the hospital's gross charges.