CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Rush Memorial Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $2,301
Cash Discount Price: $3,666
vs. Medicare Baseline: 171.84x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Rush Memorial Hospital is $2,301. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,666. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 171.84x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$3,666

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,301

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: $3,666 (27379%)

Insurance Median: $2,301 (17184%)

Cash: $3,666 (27379% of Medicare)

Ins. Median: $2,301 (17184% 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 17184% of the Medicare baseline (a markup of 17084%). 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
Health Net	$729 - $1,876	5444%
Caresource Mcr Adv	$767 - $1,974	5728%
My True Advantage - All Plans	$767 - $1,974	5728%
UnitedHealthcare	$767 - $5,095	5728%
Aetna	$775 - $5,859	5788%
Humana	$775 - $5,859	5788%
Blue Cross Blue Shield	$790 - $4,665	5900%
Today'S Option Mcr Adv-All Plans	$790 - $2,034	5900%
Viant Beech St Mcr Adv	$790 - $2,034	5900%
Caresource Marketplace-All Other Plans	$1,228 - $3,159	9171%
Cigna	$1,980 - $2,747	14787%
Phcs-All Plans	$1,980 - $5,095	14787%
Consumers Life Ins-All Plans	$2,228 - $5,732	16639%
Coventry/First Health-All Plans	$2,228 - $5,732	16639%
Sagamore-All Plans	$2,277 - $5,859	17005%
Siho-All Plans	$2,277 - $5,859	17005%
Multiplan-All Plans	$2,302 - $5,923	17192%
Community Health Alliance-All Plans	$2,327 - $5,987	17379%
Encore Health Services-All Plans	$2,426 - $6,241	18118%

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 $3,666.
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 Rush Memorial 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.