CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Sartori Memorial Hospital, Inc

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $36
Cash Discount Price: $111
vs. Medicare Baseline: 2.69x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Sartori Memorial Hospital, Inc is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.69x the Medicare baseline. Located in 515 College Street, Cedar Falls, IA.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $111 (829%)

Insurance Median: $36 (269%)

Cash: $111 (829% of Medicare)

Ins. Median: $36 (269% 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 269% of the Medicare baseline (a markup of 169%). 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	$13 - $36	97%
Blue Cross Blue Shield	$13	97%
Geha	$13	97%
Iowa Total Care	$13	97%
Medicaid / KanCare	$13	97%
Medicare (plans)	$13 - $14	97%
UnitedHealthcare	$13 - $171	97%
Amish Hospital Aid	$18	134%
Oscar	$21	157%
Ambetter / Centene	$22	164%
Centivo	$22	164%
Claimdoc	$27	202%
Nova	$27	202%
Allied Benefit Systems	$36	269%
Asr Health Benefits	$36	269%
Coventry	$36	269%
First Health	$36	269%
Lucent Health	$36	269%
Luminare Health	$36	269%
Medical Mutual	$36	269%
Meritain	$36	269%
Webtpa	$36	269%
Health Choices	$40	299%
Medical Associates	$40	299%
Health Partners	$56	418%
Auxiant	$121	904%
Cigna	$121	904%
Medica	$121	904%
Midlands	$121	904%
Midlands Choice	$121	904%
Iowa Dept Of Public Health	$171	1277%

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 $111.
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 Sartori Memorial 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.