CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Mercy Hospital Ozark

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $34
Cash Discount Price: $72
vs. Medicare Baseline: 2.54x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Mercy Hospital Ozark is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.54x the Medicare baseline. Located in 801 West River Street, Ozark, AR.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $72 (538%)

Insurance Median: $34 (254%)

Cash: $72 (538% of Medicare)

Ins. Median: $34 (254% 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 254% of the Medicare baseline (a markup of 154%). 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
Medicaid / KanCare	$12 - $45	90%
United Medical Resources Contracted [320454]	$13	97%
UnitedHealthcare	$13 - $32	97%
Summit Community Care Contracted [320368]	$18	134%
Summit Community Care [20368]	$18	134%
Blue Cross Blue Shield	$21 - $32	157%
Usable Contracted [320409]	$21	157%
Novasys Contracted [320285]	$31 - $45	232%
Aetna	$32 - $72	239%
American Health Advantage Of Mo Mcr [20264]	$32	239%
Cherokee Nation Health Serv Contracted [320066]	$32	239%
Cross Timbers Hospice [20098]	$32	239%
Dept Of Veteran Affairs Contracted [320106]	$32	239%
Elara Caring Aspire Hospice Contracted [320433]	$32	239%
Elara Caring Aspire Hospice [20433]	$32	239%
Globalhealth Contracted [320145]	$32	239%
Halo Hcr Inc Hospice Contracted [320432]	$32	239%
Halo Hcr Inc Hospice [20432]	$32	239%
Humana	$32 - $94	239%
Independent Health [20197]	$32	239%
Indian Health Service Contracted [320198]	$32	239%
Indian Health Service [20198]	$32	239%
Jordan Valley Senior Care Pace [20515]	$32	239%
Kindful Hospice Contracted [320434]	$32	239%
Kindful Hospice [20434]	$32	239%
Medical Associates Health [20444]	$32	239%
Medicare (plans)	$32 - $34	239%
Mercy Hospice Okc [20252]	$32	239%
Pace Of The Ozarks [20518]	$32	239%
Provider Partners Health Plans Contracted [320450]	$32	239%
Qual Choice Contracted [320325]	$32	239%
Spina Bifida Hlthcare Benefit [20506]	$32	239%
Tricare	$32	239%
Valir Pace [20503]	$32	239%
Wellfirst Health Mcr [20443]	$32	239%
Cigna	$34 - $94	254%
Mercy Interfacility [20513]	$36	269%
Arkansas Total Care Contracted [320039]	$41	306%
Ambetter / Centene	$45	336%
Home State Health Plan Contracted [320187]	$45	336%
Qual Choice Contracted [320324]	$56	418%
Auxiant Contracted [320462]	$66 - $99	493%
Mercy Benefit Admin Contracted [320251]	$66 - $99	493%
Workers Comp [20426]	$72	538%
90 Degree Benefits Contracted [320436]	$94	702%
Aither Health Contracted [320449]	$94	702%
Ebms Contracted [320493]	$94	702%
Edison Health Solutions Contracted [320502]	$94	702%
Healthlink Contracted [320179]	$94 - $99	702%
Imagine 360 Contracted [320494]	$94	702%
Multiplan Contracted [320270]	$94	702%
Multiplan [20270]	$94	702%
Municipal Health Plan Contracted [320271]	$94	702%
Reflect Health Contracted [320492]	$94	702%
Show-Me Health Administrators Contracted [320483]	$94	702%
Federal Medical Center Contracted [320127]	$99	739%
Healthscope Contracted [320182]	$99	739%
Insurance System Inc Contracted [320465]	$99	739%
Personify Health Contracted [320051]	$99	739%
Point C Contracted [320238]	$99	739%
Preferred Health Plan Contracted [320522]	$99	739%
Tri State Healthcare Coalition Contracted [320379]	$99	739%

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 $72.
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 Mercy Hospital Ozark 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.