CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: St Joseph's Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $27
  • Cash Discount Price: $122
  • vs. Medicare Baseline: 2.02x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at St Joseph's Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.02x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$122

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

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: $122 (911%)
Insurance Median: $27 (202%)
Cash: $122 (911% of Medicare)
Ins. Median: $27 (202% 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 202% of the Medicare baseline (a markup of 102%). 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
Sae Hospice $4 - $319 30%
Blue Cross Blue Shield $4 - $319 30%
Clear Spring Health of Illinois $4 - $319 30%
Aetna $4 - $319 30%
Molina Healthcare $4 - $319 30%
UnitedHealthcare $4 - $319 30%
Humana $4 - $319 30%
Amish Community $6 - $89 45%
Naphcare $8 - $670 60%
Celtic Insurance Company $9 - $319 67%
Hopetrust $10 - $319 75%
Claim Doc $10 - $798 75%
Wellfirst $13 - $204 97%
First Health $15 - $236 112%
Meridian Health Plan $15 112%
Healthlink $17 - $271 127%
Multiplan/Phcs $17 - $271 127%
Healthcare Finest Network (Hfn) $18 - $287 134%
Provider Network of America $18 - $287 134%
Cigna $20 - $32 149%
Current Health Solutions $20 - $319 149%
Qtc Medical Group of Illinois $20 - $319 149%
Healthscope $20 - $319 149%
Health Alliance Medical Plans $20 - $319 149%
Consociate Group $20 - $319 149%
Mental Health Network $20 - $319 149%
Interplan $20 - $319 149%
Illinois Breast and Cervical Cancer Program $20 - $319 149%
Caterpillar, Inc. $20 - $27 149%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals