CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Norton-King's Daughters' Health

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $100
Cash Discount Price: $28
vs. Medicare Baseline: 7.47x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Norton-King's Daughters' Health is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 7.47x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $28 (209%)

Insurance Median: $100 (747%)

Cash: $28 (209% of Medicare)

Ins. Median: $100 (747% 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 747% of the Medicare baseline (a markup of 647%). 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	$10 - $113	75%
Blue Cross Blue Shield	$13 - $35	97%
Humana	$13	97%
Managed Health Services Of Indiana	$13	97%
Managed Health Services Of Kentucky	$13	97%
Passport By Molina	$13	97%
UnitedHealthcare	$13 - $100	97%
Managed Health Services	$14 - $21	105%
Caresource Of Kentucky	$19	142%
Caresource Of Indiana	$20	149%
Custom Design Benefits	$27 - $64	202%
Cigna	$109	814%
Encore	$109	814%
Quality Care Partners	$114	851%
Bluegrass	$115	859%
First Health	$115	859%
Healthlink	$115	859%
Vha/Tristate	$115	859%
Multiplan/Phcs	$118	881%
Indiana Health Network	$122	911%
Siho	$122	911%

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 $28.
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 Norton-King's Daughters' Health 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.