CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Nemours Childrens Hospital, Florida

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $128
Cash Discount Price: $290
vs. Medicare Baseline: 9.56x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Nemours Childrens Hospital, Florida is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $290. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 9.56x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.

Cash / Self-Pay

$290

Average discount available for prompt cash payment at this facility.

Insurance Median

$128

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: $290 (2166%)

Insurance Median: $128 (956%)

Cash: $290 (2166% of Medicare)

Ins. Median: $128 (956% 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 956% of the Medicare baseline (a markup of 856%). 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
UnitedHealthcare	$12	90%
Tricare	$13	97%
Cigna	$17 - $117	127%
Truli	$70 - $116	523%
Florida Blue	$78 - $177	583%
Avmed	$90	672%
Employers Health Network Fl	$116	866%
Aetna	$128	956%
Evolutions Healthcare	$130	971%
Integra Administrative Group	$174	1299%
Global Medical Management	$188	1404%
Prime Health Services	$188	1404%
Star Healthcare Network	$188	1404%
Velocity	$218	1628%
First Health Network	$226	1688%
Pnoa	$232	1733%
Seminole Tribe Of Fl	$232	1733%
Private Healthcare Systems	$267	1994%

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 $290.
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 Nemours Childrens Hospital, Florida 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.