CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Piedmont Mountainside Hospital Inc

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $196
Cash Discount Price: $87
vs. Medicare Baseline: 14.64x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Piedmont Mountainside Hospital Inc is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 14.64x the Medicare baseline. Located in 1266 Highway 515 South, Jasper, GA.

Cash / Self-Pay

$87

Average discount available for prompt cash payment at this facility.

Insurance Median

$196

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: $87 (650%)

Insurance Median: $196 (1464%)

Cash: $87 (650% of Medicare)

Ins. Median: $196 (1464% 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 1464% of the Medicare baseline (a markup of 1364%). 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%
Medicaid / KanCare	$14 - $19	105%
Alliant Health Plans Of Georgia [10952]	$48	358%
Blue Cross Blue Shield	$118 - $153	881%
First Health [10303]	$177 - $229	1322%
Aetna	$180 - $233	1344%
Novanet [10819]	$190 - $246	1419%
Beechstreet [10800]	$202 - $262	1509%
Phcs [10601]	$202 - $262	1509%
Kaiser [10500]	$215 - $279	1606%
Multiplan [10600]	$215 - $279	1606%

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 $87.
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 Piedmont Mountainside Hospital Inc 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.