CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: North Shore Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $17
  • Cash Discount Price: $969
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at North Shore Medical Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $969. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.27x the Medicare baseline. Located in 1100 Nw 95Th St, Miami, FL.
Cash / Self-Pay
$969

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $969 (7237%)
Insurance Median: $17 (127%)
Cash: $969 (7237% of Medicare)
Ins. Median: $17 (127% 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.

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
Humana $5 - $387 37%
Medicaid / KanCare $5 - $969 37%
UnitedHealthcare $5 - $13 37%
Cigna $7 - $484 52%
Veterans Administration Mill Bill $9 67%
Avmed Broad Network $11 82%
Medicare (plans) $12 - $969 90%
Aetna $13 - $698 97%
Devoted Health $13 97%
Employer Direct Healthcare $13 - $17 97%
Hospice Other $13 97%
Leon Health Inc $13 97%
Tricare $13 97%
Veterans Administration Vaccn $13 97%
Healthsun Health Plans $14 105%
Longevity Health Plan $14 105%
Bright Health Management Commercial $16 119%
Centurion Prison $16 119%
Florida Pace Centers $16 119%
Imagine Health $16 119%
Oscar Health Plan Hix $16 119%
Self Pay/Uninsured $16 119%
Dimension Health Wc $19 142%
Workers Compensation $19 142%
Avmed Exchange $23 172%
Ambetter / Centene $25 187%
Molina Marketplace Program Exchange $26 194%
Auto Insurance $27 202%
Avmed Select Network $27 202%
Amerihealth Caritas Next Exchange $29 217%
Bc/Bs Myblue Hmo Hix $120 896%
Bc/Bs Of Fl Network Blue $129 963%
Bc/Bs Of Fl Ppo $129 963%
Bc/Bs Of Fl Simplyblue $129 963%
Bc/Bs Of Fl Blue Select Exchange Non Par $139 1038%
Bc/Bs Of Fl Health Options Hmo $139 1038%
Bc/Bs Of Fl Phs $502 3749%
Magellan Behavioral Health $581 4339%
Dimensions International $630 4705%
First Health $659 4922%
Dimension Health Ppo $727 5429%
Beacon Health Strategies Commercial $969 7237%
Commercial Non-Contracted $969 7237%
Self Pay - Mcd Pending 100 Percent $969 7237%
Single Case Agreement $969 7237%
United Behavioral Health Psych $969 7237%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 Nw 95Th St, Miami, FL 33150
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals