CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: UW Health

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $138
Cash Discount Price: $66
vs. Medicare Baseline: 10.31x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at UW Health is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 10.31x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$66

Average discount available for prompt cash payment at this facility.

Insurance Median

$138

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: $66 (493%)

Insurance Median: $138 (1031%)

Cash: $66 (493% of Medicare)

Ins. Median: $138 (1031% 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 1031% of the Medicare baseline (a markup of 931%). 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
Aetna	$13 - $197	97%
Blue Cross Blue Shield	$13 - $135	97%
Humana	$13	97%
Medicare (plans)	$13 - $15	97%
Mychoice Wi Medical Adv	$13	97%
UnitedHealthcare	$13 - $21	97%
Quartz Fully Insured	$17 - $95	127%
Quartz Aso	$19 - $149	142%
Ecoh	$27 - $215	202%
Hfn	$27 - $215	202%
Alliance Premier Network	$140 - $149	1046%
The Alliance	$181 - $191	1352%
Wps Ppo	$199 - $211	1486%
Cigna	$205 - $218	1531%
Beloit Healt System	$232 - $246	1733%
Mercycare	$240 - $254	1792%
First Health/Coventry	$253 - $268	1889%
Health Payment Systems	$300 - $318	2240%
Healthsmart	$300 - $318	2240%
Sheboygan Employers Health Network	$320 - $339	2390%
Multiplan	$358 - $379	2674%

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 $66.
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 UW Health 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.