CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Mercyone Elkader Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $125
Cash Discount Price: $111
vs. Medicare Baseline: 9.34x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Mercyone Elkader Medical Center is $125. 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 9.34x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$125

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: $125 (934%)

Cash: $111 (829% of Medicare)

Ins. Median: $125 (934% 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 934% of the Medicare baseline (a markup of 834%). 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	$88 - $125	657%
Blue Cross Blue Shield	$88	657%
Medicare (plans)	$89 - $92	665%
UnitedHealthcare	$94 - $128	702%
Iowa Total Care	$106	792%
Medicaid / KanCare	$107 - $108	799%
Amish Hospital Aid	$118	881%
1199 National Benefit Fund	$125	934%
Allied Benefit Systems	$125	934%
Asr Health Benefits	$125	934%
Christian Brother Services	$125	934%
Coventry	$125	934%
First Health	$125	934%
Lucent Health	$125	934%
Luminare Health	$125	934%
Medical Mutual	$125	934%
Meritain	$125	934%
Trustmark Small Business Benefits	$125	934%
Webtpa	$125	934%
Geha	$128	956%
Centivo	$133	993%
Health Choices	$136	1016%
Medical Associates	$136	1016%
Ambetter / Centene	$149	1113%
Health Partners	$164	1225%
Auxiant	$167	1247%
Cigna	$167	1247%
Medica	$167	1247%
Midlands	$167	1247%
Midlands Choice	$167	1247%
Crime Victim Assistance	$170	1270%
Iowa Dept Of Public Health	$170	1270%
Claimdoc	$178	1329%
Nova	$178	1329%

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 Mercyone Elkader Medical Center 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.