CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Kirby Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $147
  • Cash Discount Price: $177
  • vs. Medicare Baseline: 10.98x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Kirby Medical Center is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 10.98x the Medicare baseline. Located in 1000 Medical Center Drive, Monticello, IL.
Cash / Self-Pay
$177

Average discount available for prompt cash payment at this facility.

Insurance Median
$147

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: $177 (1322%)
Insurance Median: $147 (1098%)
Cash: $177 (1322% of Medicare)
Ins. Median: $147 (1098% 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 1098% of the Medicare baseline (a markup of 998%). 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
Aetna $9 - $206 67%
Blue Cross Blue Shield $9 - $289 67%
Meridian $9 - $91 67%
Molina $10 - $94 75%
UnitedHealthcare $11 - $203 82%
Humana $18 - $221 134%
Wellcare $91 680%
Cigna $236 1763%
Catepillar, Inc. $251 1875%
Healthlink $266 1987%
Zelis (Hfn) $266 1987%
Multiplan/Phcs $280 2091%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Medical Center Drive, Monticello, IL 61856
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals