CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Fishermen's Community Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $53
Cash Discount Price: $101
vs. Medicare Baseline: 3.96x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Fishermen's Community Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.96x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.

Cash / Self-Pay

$101

Average discount available for prompt cash payment at this facility.

Insurance Median

$53

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: $101 (754%)

Insurance Median: $53 (396%)

Cash: $101 (754% of Medicare)

Ins. Median: $53 (396% 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 396% of the Medicare baseline (a markup of 296%). 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 - $193	37%
Amerigroup	$5	37%
Medicaid / KanCare	$5	37%
Sunshine State	$5	37%
UnitedHealthcare	$5 - $252	37%
Vista	$5	37%
Wellcare	$5	37%
Blue Cross Blue Shield	$10 - $252	75%
Leon Medical	$12 - $53	90%
Medica Health Plan	$12 - $53	90%
Medicare (plans)	$12 - $71	90%
Avmed	$14 - $209	105%
Cigna	$14 - $202	105%
Humana	$14 - $58	105%
Non Contracted	$22 - $92	164%
International	$38 - $164	284%
Amerihealth	$44 - $189	329%
Dimension Health Plan	$44 - $227	329%
Affordable	$53 - $227	396%
Phcs	$53 - $227	396%
Quality Health	$53 - $227	396%

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 $101.
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 Fishermen's Community 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.