CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Fayette County Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $167
Cash Discount Price: $256
vs. Medicare Baseline: 12.47x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Fayette County Hospital is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $256. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 12.47x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$256

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $256 (1912%)

Insurance Median: $167 (1247%)

Cash: $256 (1912% of Medicare)

Ins. Median: $167 (1247% 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 1247% of the Medicare baseline (a markup of 1147%). 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	$14 - $194	105%
Blue Cross Blue Shield	$14 - $236	105%
Illinicare - All Plans	$14	105%
Medicaid / KanCare	$14	105%
Meridian-All Plans	$14	105%
Health Alliance Mcare	$74 - $90	553%
Healthlink Mcr Adv	$74 - $90	553%
Humana	$74 - $90	553%
Coventry/Ghp-All Plans	$150 - $183	1120%
Healthlink Hmo	$161 - $197	1202%
Cigna	$172 - $211	1285%
Healthlink Ppo - All Other Plans	$184 - $225	1374%
Health Alliance - All Other Plans	$190 - $232	1419%
UnitedHealthcare	$191 - $233	1426%
Multiplan - All Plans	$196 - $239	1464%

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 $256.
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 Fayette County Hospital 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.