CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Montrose Regional Health

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $45
Cash Discount Price: $56
vs. Medicare Baseline: 3.36x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Montrose Regional Health is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.36x the Medicare baseline. Located in 800 S 3Rd St, Montrose, CO.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $56 (418%)

Insurance Median: $45 (336%)

Cash: $56 (418% of Medicare)

Ins. Median: $45 (336% 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 336% of the Medicare baseline (a markup of 236%). 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
United Rocky Mountain Chp-All Other Plans	$6 - $44	45%
United Rocky Mountain Private Plan	$6 - $94	45%
United Rocky Mountain Self Insured	$6 - $97	45%
United Rocky Mountain Mcaid	$7 - $47	52%
UnitedHealthcare	$8 - $97	60%
Blue Cross Blue Shield	$13 - $96	97%
Humana	$13 - $97	97%
Medicare (plans)	$13	97%
Montrose Community Healthplan-All Plans	$19 - $87	142%
Three Rivers-All Plans	$42 - $97	314%
Western Healthcare Alliance-All Plans	$42 - $92	314%
Cigna	$45 - $97	336%
Multiplan-All Plans	$45 - $97	336%
Uchpa - All Plans	$45 - $97	336%
Sloans Lake Managed Care-All Plans	$97	724%

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 $56.
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 Montrose Regional Health 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.