CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Hamilton Memorial Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $108
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 8.07x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Hamilton Memorial Hospital is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 8.07x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$108

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: $114 (851%)
Insurance Median: $108 (807%)
Cash: $114 (851% of Medicare)
Ins. Median: $108 (807% 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 807% of the Medicare baseline (a markup of 707%). 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
Medicaid / KanCare $50 - $54 373%
Blue Cross Blue Shield $51 - $122 381%
Aetna $54 - $121 403%
Health Alliance $54 - $108 403%
Humana $54 403%
Medicare (plans) $54 403%
UnitedHealthcare $54 - $96 403%
Wellcare $54 403%
Alliance Coal $94 702%
Healthscope $94 702%
Wellfirst (Ssmhic) $94 702%
Hope Trust $101 754%
Cigna $106 792%
Hfn, Inc $108 - $121 807%
Healthlink $114 - $121 851%
Multiplan $114 851%
Siho $121 904%
Three Rivers Provider $121 904%
Healthsmart $128 956%
Stratose $128 956%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 S Marshall Avenue, McLeansboro, IL 62859
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals