CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Cass County Memorial Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $57
Cash Discount Price: $93
vs. Medicare Baseline: 4.26x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Cass County Memorial Hospital is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 4.26x the Medicare baseline. Located in 1501 East Tenth Street, Atlantic, IA.

Cash / Self-Pay

$93

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $93 (695%)

Insurance Median: $57 (426%)

Cash: $93 (695% of Medicare)

Ins. Median: $57 (426% 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 426% of the Medicare baseline (a markup of 326%). 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
UnitedHealthcare	$13 - $56	97%
Midlands Choice Medica Mcr	$27	202%
Triwest - All Plans	$54	403%
Aetna	$56 - $126	418%
Amerigroup Mcr Adv - All Other Plans	$56	418%
Medica Mcr Adv	$56	418%
Tricare	$56	418%
Va Ccn - All Plans	$56	418%
Wellmark Mcr Adv	$56	418%
Iowa Total Care Mcaid	$57	426%
Iowa Total Care Mcr	$57	426%
Molina Mcaid - All Plans	$57	426%
American Hlth Mcr Adv - All Plans	$58	433%
Medicaid / KanCare	$58	433%
Iowa Total Care Comm - All Other Plans	$61	456%
Wellmark Hmo	$64	478%
Wellmark Ppo - All Other Plans	$71	530%
Midlands Choice New Bus	$86	642%
Medica Comm - All Other Plans	$117	874%
Midlands Choice Pho (Ppo) - All Other Plans	$120	896%
Multiplan - All Plans	$126	941%

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 $93.
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 Cass County Memorial 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.