CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Elkhart General Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $91
Cash Discount Price: $98
vs. Medicare Baseline: 6.80x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Elkhart General Hospital is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 6.80x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$98

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $98 (732%)

Insurance Median: $91 (680%)

Cash: $98 (732% of Medicare)

Ins. Median: $91 (680% 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 680% of the Medicare baseline (a markup of 580%). 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
Mclaren (Mi	$7	52%
UnitedHealthcare	$7 - $101	52%
Blue Cross Blue Shield	$11 - $37	82%
Aetna	$13 - $102	97%
Caresource	$13 - $196	97%
Humana	$13 - $106	97%
Mdwise	$13 - $196	97%
Mhs	$13 - $196	97%
Pace	$13	97%
Devoted Healthcare	$14 - $30	105%
Plain Church	$20 - $121	149%
Cha	$91 - $118	680%
Immergrun	$91 - $121	680%
Php	$98 - $106	732%
Cigna	$109 - $115	814%
Multiplan	$109	814%
Signature	$110	822%
Encore	$112	836%
Heartland	$151	1128%

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 $98.
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 Elkhart General 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.