CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Decatur Memorial Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $151
Cash Discount Price: $327
vs. Medicare Baseline: 11.28x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Decatur Memorial Hospital is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $327. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 11.28x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$327

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $327 (2442%)

Insurance Median: $151 (1128%)

Cash: $327 (2442% of Medicare)

Ins. Median: $151 (1128% 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 1128% of the Medicare baseline (a markup of 1028%). 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
Medicaid / KanCare	$9	67%
Blue Cross Blue Shield	$12 - $327	90%
Aetna	$13 - $219	97%
Coventry	$13 - $166	97%
Health Alliance	$13 - $217	97%
Humana	$13 - $213	97%
Medicare (plans)	$13	97%
Tricare	$13	97%
UnitedHealthcare	$13 - $327	97%
Veterans Administration	$13	97%
Wellcare	$13	97%
Caterpillar	$17	127%
Plain Church Medical Group	$18 - $147	134%
Illinois Workers Compensation	$73 - $119	545%
Hfn	$112 - $245	836%
Commercial Workers Compensation	$114	851%
Mennonite Churches	$114	851%
Health Alliance Mh Employee Plan	$150	1120%
Cigna	$152	1135%
6 Degrees Health	$196	1464%
Hopetrust	$196	1464%
Hst	$196	1464%
Phcs Savility	$213	1591%
Phcs Multiplan Ppo	$222	1658%
Healthlink	$224	1673%
Corvel	$235	1755%
Consociate	$242	1807%
Liability	$327	2442%

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 $327.
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 Decatur 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.