CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Saint Joseph Regional Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $92
  • Cash Discount Price: $226
  • vs. Medicare Baseline: 6.87x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Saint Joseph Regional Medical Center is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $226. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 6.87x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$226

Average discount available for prompt cash payment at this facility.

Insurance Median
$92

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: $226 (1688%)
Insurance Median: $92 (687%)
Cash: $226 (1688% of Medicare)
Ins. Median: $92 (687% 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 687% of the Medicare baseline (a markup of 587%). 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 $7 - $170 52%
Blue Cross Blue Shield $7 - $27 52%
Medicaid / KanCare $7 - $13 52%
UnitedHealthcare $7 - $222 52%
Managed Health Services - Indiana $13 97%
Mdwise $13 97%
Medicare (plans) $13 - $14 97%
Meridian Complete $13 97%
Pace-Trinity Health $13 97%
County Coroner $14 105%
Provider Partners Health Plan Of Indiana $15 112%
Auxiant $20 - $289 149%
Physicians Health Plan Northern Indiana Health Insurance $20 - $40 149%
St Joseph County Hlth Dpt $20 149%
Caresource $21 157%
Siho Insurance Services $21 157%
Key Benefit Administrator $24 - $217 179%
Allied Benefit Systems $25 - $226 187%
Blue Benefit Administrators Of Massachusetts $27 202%
Blue Care Network $27 202%
Blue Distinction Transplant $27 202%
Blue Shield - Ca $27 202%
Blue Shield - Id (Regence) $27 202%
Blue Shield - Ny Highmark Northeastern $27 202%
Blue Shield - Ny Highmark Western $27 202%
Blue Shield - Pa (Highmark) $27 202%
Blue Shield - Wa (Regence) $27 202%
Custom Design Benefits $29 217%
Hospice Of Marshall County $90 672%
Hospice Of St Joseph County $90 672%
Plain Church Group $94 702%
Asr Health Benefits $170 1270%
Christian Brother Services $170 1270%
Employee Benefit Management $170 1270%
Medical Mutual $170 1270%
Meritain $170 1270%
Preferred One $170 1270%
Rural Carrier Health Benefit Plan $170 1270%
Webtpa $170 1270%
Notre Dame Athletic Association $191 1426%
Wc Notre Dame $191 1426%
Luminare Health (Detroit) $198 - $209 1479%
Encore Health $206 - $217 1538%
Ameriben $209 1561%
Indiana Criminal Justice Inst $217 1621%
Western & Southern Financial Group $217 1621%
Geha $222 1658%
Healthscope $222 1658%
Student Insurance Cma $222 1658%
Cigna $223 1665%
Group Administrators $223 1665%
Health Partners $223 1665%
Mvp $223 1665%
Prairie States $223 1665%
Priority Health $223 1665%
Professional Benefit Administrators $223 1665%
Sagamore Health Network $223 - $258 1665%
Sisco Benefits $223 1665%
Unified Group Services $223 1665%
Goshen Preferred Network $268 - $299 2001%
Christian Brothers Holy Cross $278 2076%
Signature Care $278 2076%
Bankers Life Casualty $348 2599%
Bureau Of Disability $348 2599%
Wc Align Network $348 2599%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals