CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $212
  • Cash Discount Price: $170
  • vs. Medicare Baseline: 15.83x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at HSHS St Elizabeth's Hospital is $212. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 15.83x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$170

Average discount available for prompt cash payment at this facility.

Insurance Median
$212

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: $170 (1270%)
Insurance Median: $212 (1583%)
Cash: $170 (1270% of Medicare)
Ins. Median: $212 (1583% 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 1583% of the Medicare baseline (a markup of 1483%). 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
Meridian Health Plan $7 52%
Molina Healthcare $7 - $236 52%
Aetna $13 - $236 97%
Blue Cross Blue Shield $13 - $236 97%
Clear Spring Health Of Illinois $13 - $236 97%
Health Alliance Medical Plans $13 - $236 97%
Health Partners $13 - $236 97%
Humana $13 - $236 97%
Sae Hospice $13 - $236 97%
UnitedHealthcare $13 - $236 97%
Celtic Insurance Company $29 - $236 217%
Naphcare $30 - $236 224%
Claim Doc $33 - $236 246%
Hopetrust $33 - $236 246%
Amish Community $66 493%
Wellfirst $152 1135%
First Health $176 1314%
Cigna $186 - $236 1389%
Healthlink $188 - $236 1404%
Caterpillar, Inc. $190 1419%
Consociate Group $208 1553%
Choicecare $212 1583%
Healthcare Finest Network (Hfn) $212 1583%
Multiplan/Phcs $212 1583%
Provider Network Of America $212 1583%
City Of Springfield $236 1763%
Current Health Solutions $236 1763%
Healthscope $236 1763%
Illinois Breast And Cervical Cancer Program $236 1763%
Interplan $236 1763%
Live360 $236 1763%
Wexford $236 1763%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals