CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Fairview Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $54
  • Cash Discount Price: $116
  • vs. Medicare Baseline: 4.03x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Fairview Hospital is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 4.03x the Medicare baseline. Located in 29 Lewis Avenue, Great Barrington, MA.
Cash / Self-Pay
$116

Average discount available for prompt cash payment at this facility.

Insurance Median
$54

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: $116 (866%)
Insurance Median: $54 (403%)
Cash: $116 (866% of Medicare)
Ins. Median: $54 (403% 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 403% of the Medicare baseline (a markup of 303%). 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
Capital District Physicians' Health Plan $6 - $110 45%
Medicaid / KanCare $6 - $12 45%
Bmchnp $7 - $14 52%
Health New England $7 - $85 52%
Aetna $13 - $92 97%
Hospice $13 - $48 97%
Medicare (plans) $13 - $47 97%
Other Government $13 - $48 97%
Point32Health $13 - $116 97%
UnitedHealthcare $13 - $105 97%
Fallon $14 - $54 105%
Blue Cross Blue Shield $15 - $104 112%
Commcare Alliance $16 - $47 119%
Comm Fallon Qhp $20 - $75 149%
Unicare $35 - $79 261%
Allways Nhp $47 - $79 351%
Workers Comp $47 - $78 351%
Comm Hne Hmo $48 - $92 358%
Comm Hne Ppo $51 - $92 381%
Cigna $66 - $113 493%
Mvp $66 - $110 493%
Oxford $66 - $110 493%
First Health $68 - $116 508%
Connecticare $69 - $116 515%
Consolidated Health Plans $69 - $116 515%
Other Commercial $69 - $116 515%
Phcs $69 - $116 515%
Self Pay $69 - $116 515%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 29 Lewis Avenue, Great Barrington, MA 01230
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals