CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Cleveland Clinic Martin North Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $15
Cash Discount Price: $32
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Cleveland Clinic Martin North Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.12x the Medicare baseline. Located in 200 Se Hospital Ave, Stuart, FL.

Cash / Self-Pay

$32

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $32 (239%)

Insurance Median: $15 (112%)

Cash: $32 (239% of Medicare)

Ins. Median: $15 (112% 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.

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
Aetna	$8 - $160	60%
Amerihealth	$8	60%
Avmed	$8 - $68	60%
Freedom Health	$8 - $14	60%
Miami Childrens Health Plan	$8 - $13	60%
Molina	$8	60%
Sunshine Health	$8	60%
United	$8 - $13	60%
Independent Living Systems	$10	75%
Blue Cross Blue Shield	$13 - $15	97%
Humana	$13	97%
Wellcare	$13	97%
Bmi	$14 - $98	105%
Careplus	$14	105%
Cigna	$14 - $35	105%
Devoted Health	$15	112%
Clarity Health	$17 - $116	127%
The Legacy Companies	$17 - $116	127%
Consociate Health	$56	418%

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 $32.
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 Cleveland Clinic Martin North Hospital 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.