CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $313
Cash Discount Price: $457
vs. Medicare Baseline: 23.38x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Children's Healthcare of Atlanta at Scottish Rite is $313. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $457. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 23.38x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$457

Average discount available for prompt cash payment at this facility.

Insurance Median

$313

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: $457 (3413%)

Insurance Median: $313 (2338%)

Cash: $457 (3413% of Medicare)

Ins. Median: $313 (2338% 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 2338% of the Medicare baseline (a markup of 2238%). 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
Caresource [61]	$19	142%
Peachstate [43]	$19	142%
Amerigroup [102]	$22	164%
Cigna	$302	2255%
Blue Cross Blue Shield	$303 - $446	2263%
United [5]	$303	2263%
Ambetter / Centene	$306	2285%
Oscar [228]	$306	2285%
Aetna	$308	2300%
Caresource Marketplace Bronze/Silver/Gold [60]	$311	2323%
Kaiser [6]	$311	2323%
Sidecar Health [236]	$315	2353%
Direct Employer Agreements [72]	$320 - $388	2390%
Coventry [9]	$321	2397%
First Health [74]	$343	2562%
Northeast Georgia Heatlh System [808]	$343	2562%
Veracity Benefits [809]	$343	2562%
Phcs [93]	$388	2898%
Secure Health [340]	$388	2898%
Beech Street [71]	$411	3069%
Multiplan [92]	$448	3346%
Novanet [41]	$457	3413%

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 $457.
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 Children's Healthcare of Atlanta at Scottish Rite 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.