CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Boone County Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $43
Cash Discount Price: $83
vs. Medicare Baseline: 3.21x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Boone County Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.21x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$83

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $83 (620%)

Insurance Median: $43 (321%)

Cash: $83 (620% of Medicare)

Ins. Median: $43 (321% 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 321% of the Medicare baseline (a markup of 221%). 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
Va Ccn-All Plans	$3 - $14	22%
Aetna	$9 - $81	67%
Amerigroup Mcr Adv - All Other Plans	$9 - $43	67%
Choice Care Mcr Adv - All Plans	$9 - $43	67%
Humana	$9 - $94	67%
Iowa Hlth Adv - All Plans	$9 - $43	67%
Iowa Total Care Mcaid - All Plans	$10 - $48	75%
UnitedHealthcare	$12 - $61	90%
Tricare	$13	97%
Healthsmart Accell Network	$15 - $73	112%
Medical Associates Hp-All Plans	$16 - $78	119%
Health Alliance-All Plans	$19 - $94	142%
Midlands Choice-All Plans	$19 - $96	142%
Mt Carmel Hp - All Plans	$43	321%
Meridian Mcaid - All Plans	$47	351%
Medicaid / KanCare	$48	358%
Wellmark Hmo	$52	388%
Wellmark Ppo - All Other Plans	$57	426%
Healthsmart Ppo - All Other Plans	$83	620%
Mutually Preferred-All Plans	$99	739%

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 $83.
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 Boone County Hospital 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.