CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Morton Plant North Bay Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $39
Cash Discount Price: $34
vs. Medicare Baseline: 2.91x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Morton Plant North Bay Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.91x the Medicare baseline. Located in 6600 Madison Street, New Port Richey, FL.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $34 (254%)

Insurance Median: $39 (291%)

Cash: $34 (254% of Medicare)

Ins. Median: $39 (291% 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 291% of the Medicare baseline (a markup of 191%). 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
Aetna	$5 - $279	37%
Clear Health Alliance	$5	37%
Florida Community Care	$5	37%
Freedom Health	$5	37%
Humana	$5 - $17	37%
Molina Healthcare	$5	37%
Simply Healthcare	$5 - $62	37%
Sunshine Health	$5	37%
UnitedHealthcare	$5 - $308	37%
Molina	$8 - $202	60%
Freedom	$9 - $68	67%
Optimum	$9 - $68	67%
Careplus	$10 - $78	75%
Avmed	$13 - $168	97%
Baycareplus	$13	97%
Blue Cross Blue Shield	$13 - $181	97%
Ultimate Health Plan	$13 - $103	97%
Cigna	$15 - $298	112%
Solis Health	$15	112%
Wellcare	$19	142%
Evolutions	$22 - $318	164%
Ambetter / Centene	$30 - $342	224%
First Health	$37 - $291	276%
Multiplan	$39 - $308	291%
United Behavioral Health	$43 - $342	321%

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 $34.
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 Morton Plant North Bay 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.