CMS Price Transparency Data
Blood test, cholesterol (lipid panel)
Facility: St Joe Mercy Hospital System Livonia
Billing Code: 80061 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80061
- Insurance Median: $48
- Cash Discount Price: $224
- vs. Medicare Baseline: 3.58x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at St Joe Mercy Hospital System Livonia is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.58x the Medicare baseline. Located in 36475 Five Mile Road, Livonia, MI.
Cash / Self-Pay
$224
Average discount available for prompt cash payment at this facility.
Insurance Median
$48
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: $224 (1673%)
Insurance Median: $48 (358%)
Cash: $224 (1673% of Medicare)
Ins. Median: $48 (358% 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 358% of the Medicare baseline (a markup of 258%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $7 - $14 | 52% |
| Medicaid / KanCare | $7 | 52% |
| Aetna | $13 - $49 | 97% |
| Align Senior Care | $13 | 97% |
| Angela Hospice | $13 | 97% |
| Blue Care Network Advantage | $13 | 97% |
| Hospice Of Michigan | $13 | 97% |
| Medicare (plans) | $13 - $14 | 97% |
| Bcn Domestic | $14 | 105% |
| Blue Benefit Administrators Of Massachusetts | $14 | 105% |
| Blue Care Network | $14 | 105% |
| Blue Distinction Transplant | $14 | 105% |
| Blue Shield - Ca | $14 | 105% |
| Blue Shield - Id (Regence) | $14 | 105% |
| Blue Shield - Ny Highmark Northeastern | $14 | 105% |
| Blue Shield - Ny Highmark Western | $14 | 105% |
| Blue Shield - Pa (Highmark) | $14 | 105% |
| Blue Shield - Wa (Regence) | $14 | 105% |
| Cca - Zing Health | $14 | 105% |
| Health Choices | $14 - $71 | 105% |
| Kaiser Domestic | $14 | 105% |
| UnitedHealthcare | $14 - $72 | 105% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $15 | 112% |
| Molina Marketplace | $17 | 127% |
| Geha | $20 - $72 | 149% |
| Luminare Health (Detroit) | $20 | 149% |
| Meritain | $20 | 149% |
| Health Cost Solutions | $21 | 157% |
| Vitalcore | $21 | 157% |
| Wellpath | $21 | 157% |
| U Of M Health Plan | $25 | 187% |
| Employee Benefit Logistic | $30 | 224% |
| Priority Health | $30 - $34 | 224% |
| Wc Accident Fund | $32 | 239% |
| Wc Advantage | $32 | 239% |
| Wc Aig | $32 | 239% |
| Wc Allied | $32 | 239% |
| Wc Amerisure | $32 | 239% |
| Wc Amtrust | $32 | 239% |
| Wc Asu Risk Mgt | $32 | 239% |
| Wc Berkley Admin | $32 | 239% |
| Wc Broadspire | $32 | 239% |
| Wc Bunch & Associates | $32 | 239% |
| Wc Ccmsi | $32 | 239% |
| Wc Emc Insurance Company | $32 | 239% |
| Wc Esis | $32 | 239% |
| Wc Fcci | $32 | 239% |
| Wc Federated | $32 | 239% |
| Wc Gallagher Bassett | $32 | 239% |
| Wc Genex Care For Ohio | $32 | 239% |
| Wc Guard Insurance Company | $32 | 239% |
| Wc Hartford | $32 | 239% |
| Wc Liberty Mutual | $32 | 239% |
| Wc Meijers | $32 | 239% |
| Wc Michigan | $32 | 239% |
| Wc Mitchell Frankenmuth | $32 | 239% |
| Wc Pma | $32 | 239% |
| Wc Sedgwick | $32 | 239% |
| Wc Sentry | $32 | 239% |
| Wc Travelers | $32 | 239% |
| Wc Tristar | $32 | 239% |
| Wc Walmart | $32 | 239% |
| Wc Zurich | $32 | 239% |
| Acs Benefit Services | $48 | 358% |
| Allied Benefit Systems | $48 | 358% |
| Claimchoice Adminstrators | $48 | 358% |
| Consociate | $48 | 358% |
| Cypress Benefit Administrators | $48 | 358% |
| Forest County Potawatomi | $48 | 358% |
| Health Smart | $48 | 358% |
| Healthgram | $48 | 358% |
| Healthscope | $48 | 358% |
| Secureone Preferred United Plans | $48 | 358% |
| Sisco Benefits | $48 | 358% |
| The Health Plan | $48 | 358% |
| Trustmark Small Business Benefits | $48 | 358% |
| Unified Group Services | $48 | 358% |
| Webtpa | $48 | 358% |
| Asr Health Benefits | $50 | 373% |
| Caresource | $50 | 373% |
| Hap | $50 - $69 | 373% |
| Varipro | $50 | 373% |
| Health Partners | $69 | 515% |
| Tufts Health Plan | $69 | 515% |
| Cigna | $70 - $90 | 523% |
| Access Health | $71 | 530% |
| Acclaim | $71 | 530% |
| Administrative Concepts | $71 | 530% |
| Allegeant | $71 | 530% |
| Ameriben | $71 | 530% |
| American Family | $71 | 530% |
| American Healthcare Alliance | $71 | 530% |
| American National | $71 | 530% |
| American Republic | $71 | 530% |
| Amerihealth | $71 | 530% |
| Aultcare | $71 | 530% |
| Automated Benefit Services | $71 | 530% |
| Auxiant | $71 | 530% |
| Benefit Administrative Systems,Llc | $71 | 530% |
| Boon Chapman | $71 | 530% |
| Cam Administrative Services | $71 | 530% |
| Christian Brother Services | $71 | 530% |
| Christian Brothers Holy Cross | $71 | 530% |
| Comprehensive Benefits | $71 | 530% |
| Continental Life Insurance | $71 | 530% |
| Custom Benefit Administrators | $71 | 530% |
| Employee Benefit Concepts | $71 | 530% |
| Employee Benefit Management | $71 | 530% |
| Enterprise Group Planning | $71 | 530% |
| Freedom Life Insurance Company | $71 | 530% |
| Group Administrators | $71 | 530% |
| Group Marketing Services | $71 | 530% |
| Guardian | $71 | 530% |
| Health America | $71 | 530% |
| Healthcare Management Admin | $71 | 530% |
| Healthez | $71 | 530% |
| Humana | $71 | 530% |
| Insight | $71 | 530% |
| Intercare | $71 | 530% |
| Jfp Benefit Management | $71 | 530% |
| Jp Farley Corporation | $71 | 530% |
| Key Benefit Administrator | $71 | 530% |
| Liberty Union Life Assurance Co | $71 | 530% |
| Lucent Health | $71 | 530% |
| Luminare Health | $71 | 530% |
| Magnacare | $71 | 530% |
| Medben | $71 | 530% |
| Medcost | $71 | 530% |
| Medical Mutual | $71 | 530% |
| Mutual Health Services | $71 | 530% |
| Mutual Of Omaha | $71 | 530% |
| Ncas | $71 | 530% |
| Nippon Life Ins | $71 | 530% |
| Nova | $71 | 530% |
| Painters Union Insurance Fund | $71 | 530% |
| Physicians Mutual | $71 | 530% |
| Plumbers Local 98 Insurance Fund | $71 | 530% |
| Prairie States | $71 | 530% |
| Preferred One | $71 | 530% |
| Primary Physician Care | $71 | 530% |
| Professional Benefit Administrators | $71 | 530% |
| Siho Insurance Services | $71 | 530% |
| The Loomis Company | $71 | 530% |
| Unicare | $71 | 530% |
| Us Health And Life | $71 | 530% |
| Valenz | $71 | 530% |
| Western & Southern Financial Group | $71 | 530% |
| Wps | $71 | 530% |
| 1199 National Benefit Fund | $72 | 538% |
| Allied National Global Care | $72 | 538% |
| Asrm - Reliance Standard Life Insurance | $72 | 538% |
| Christian Care Ministry | $72 | 538% |
| Dean Health | $72 | 538% |
| Fallon Health | $72 | 538% |
| Family Life Insurance Company | $72 | 538% |
| Ghc Scw | $72 | 538% |
| Group Pension Administrators | $72 | 538% |
| International Benefit Administrators | $72 | 538% |
| Lifetime Benefit Solutions | $72 | 538% |
| Manhattan Life | $72 | 538% |
| Medi Share | $72 | 538% |
| Multiplan | $72 | 538% |
| Mvp | $72 | 538% |
| Pai | $72 | 538% |
| Pan-American Life | $72 | 538% |
| Paramount Hmo | $72 | 538% |
| Phcs | $72 | 538% |
| Trinity Health Share | $72 | 538% |
| First Health | $73 | 545% |
| Coventry | $90 | 672% |
| Prime Health Services | $90 | 672% |
| Three Rivers Provider Network | $101 | 754% |
| Carelon Behavioral Health | $112 | 836% |
| Cmh Detroit Wayne Integrated Health Network | $112 | 836% |
| Cmh Lenawee County | $112 | 836% |
| Cmh Livingston County | $112 | 836% |
| Cmh Misc | $112 | 836% |
| Cmh Monroe County | $112 | 836% |
| Cmh Washtenaw County | $112 | 836% |
| Magellan Behavioral Health | $112 | 836% |