CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Decatur County Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $33
  • Cash Discount Price: $60
  • vs. Medicare Baseline: 2.46x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Decatur County Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.46x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$60

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

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: $60 (448%)
Insurance Median: $33 (246%)
Cash: $60 (448% of Medicare)
Ins. Median: $33 (246% 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 246% of the Medicare baseline (a markup of 146%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $4 - $99 30%
Blue Cross Blue Shield $9 - $37 67%
Champva -All Plans $12 - $53 90%
Everystep Hospice-All Plans $14 - $61 105%
Aetna $15 - $92 112%
Tricare $15 - $63 112%
Benefit Admin System-All Plans $18 - $76 134%
All Savers-All Plans $20 - $88 149%
Allied Benefit System-All Plans $20 - $88 149%
American Family Ins Grp-All Plans $20 - $88 149%
Humana $20 - $85 149%
Meritain Health-All Plans $20 - $85 149%
Misc Commercial-All Plans $20 - $85 149%
Rural Carrier Benefit Plan-All Plans $21 - $90 157%
Christian Healthcare -All Plans $22 - $94 164%
Medica-All Other Plans $22 - $94 164%
Cigna $23 - $101 172%
Golden Rule-All Plans $23 - $99 172%
Ntca The Rural Broadband-All Plans $23 - $99 172%
Farm Bureau Financial-All Other Plans $24 - $105 179%
Farm Bureau Property And Ca $24 - $105 179%
Medical Mutual-All Plans $24 - $103 179%
Health Partners-All Plans $25 - $108 187%
Medi Share-All Plans $25 - $106 187%
Uhss-All Plans $25 - $106 187%
Lewermark-All Plans $26 - $111 194%
Mail Handlers Benefit-All Plans $26 - $115 194%
Midlands Choice-All Plans $26 - $115 194%
Priority Health-All Plans $27 - $117 202%
Amerigroup Mcaid-All Plans $28 - $123 209%
Iowa Total Care Mcaid-All Plans $28 - $119 209%
Wellmark Hmo $52 388%
Wellmark Ppo - All Other Plans $57 426%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals