CMS Price Transparency Data
Blood test, cholesterol (lipid panel)
Facility: Mercy Health Saint Mary's
Billing Code: 80061 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80061
- Insurance Median: $64
- Cash Discount Price: $57
- vs. Medicare Baseline: 4.78x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Mercy Health Saint Mary's is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 4.78x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$57
Average discount available for prompt cash payment at this facility.
Insurance Median
$64
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: $57 (426%)
Insurance Median: $64 (478%)
Cash: $57 (426% of Medicare)
Ins. Median: $64 (478% 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 478% of the Medicare baseline (a markup of 378%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $7 - $20 | 52% |
| Medicaid / KanCare | $7 | 52% |
| Access Health | $9 | 67% |
| Aetna | $13 - $38 | 97% |
| Align Senior Care | $13 | 97% |
| Blue Care Network Advantage | $13 | 97% |
| Correctional Recovery | $13 | 97% |
| Hospice Faith | $13 | 97% |
| Hospice Of Holland | $13 | 97% |
| Medicare (plans) | $13 | 97% |
| Oscar | $13 | 97% |
| UnitedHealthcare | $14 - $87 | 105% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $15 | 112% |
| Molina Marketplace | $17 | 127% |
| Bcn Domestic | $20 | 149% |
| Blue Benefit Administrators Of Massachusetts | $20 | 149% |
| Blue Care Network | $20 | 149% |
| Blue Distinction Transplant | $20 | 149% |
| Blue Shield - Ca | $20 | 149% |
| Blue Shield - Id (Regence) | $20 | 149% |
| Blue Shield - Ny Highmark Northeastern | $20 | 149% |
| Blue Shield - Ny Highmark Western | $20 | 149% |
| Blue Shield - Pa (Highmark) | $20 | 149% |
| Blue Shield - Wa (Regence) | $20 | 149% |
| Geha | $20 - $66 | 149% |
| Health Choices | $20 - $66 | 149% |
| Kaiser Domestic | $20 | 149% |
| Medical Mutual | $20 | 149% |
| Meritain | $20 | 149% |
| Preferred One | $20 | 149% |
| Vitalcore | $21 | 157% |
| Wellpath | $21 | 157% |
| U Of M Health Plan | $25 - $66 | 187% |
| Wc Accident Fund | $48 | 358% |
| Wc Advantage | $48 | 358% |
| Wc Aig | $48 | 358% |
| Wc Allied | $48 | 358% |
| Wc Amerisure | $48 | 358% |
| Wc Amtrust | $48 | 358% |
| Wc Asu Risk Mgt | $48 | 358% |
| Wc Berkley Admin | $48 | 358% |
| Wc Broadspire | $48 | 358% |
| Wc Bunch & Associates | $48 | 358% |
| Wc Ccmsi | $48 | 358% |
| Wc Emc Insurance Company | $48 | 358% |
| Wc Esis | $48 | 358% |
| Wc Fcci | $48 | 358% |
| Wc Federated | $48 | 358% |
| Wc Gallagher Bassett | $48 | 358% |
| Wc Genex Care For Ohio | $48 | 358% |
| Wc Guard Insurance Company | $48 | 358% |
| Wc Hartford | $48 | 358% |
| Wc Liberty Mutual | $48 | 358% |
| Wc Meijers | $48 | 358% |
| Wc Michigan | $48 | 358% |
| Wc Mitchell Frankenmuth | $48 | 358% |
| Wc Pma | $48 | 358% |
| Wc Sedgwick | $48 | 358% |
| Wc Sentry | $48 | 358% |
| Wc Travelers | $48 | 358% |
| Wc Tristar | $48 | 358% |
| Wc Walmart | $48 | 358% |
| Wc Zurich | $48 | 358% |
| Nomi Health | $49 | 366% |
| Acs Benefit Services | $50 | 373% |
| Allied Benefit Systems | $50 | 373% |
| Claimchoice Adminstrators | $50 | 373% |
| Consociate | $50 | 373% |
| Cypress Benefit Administrators | $50 | 373% |
| Forest County Potawatomi | $50 | 373% |
| Health Smart | $50 | 373% |
| Healthgram | $50 | 373% |
| Healthscope | $50 | 373% |
| Secureone Preferred United Plans | $50 | 373% |
| Sisco Benefits | $50 | 373% |
| The Health Plan | $50 | 373% |
| Trustmark Small Business Benefits | $50 | 373% |
| Unified Group Services | $50 | 373% |
| Webtpa | $50 | 373% |
| Asr Health Benefits | $55 | 411% |
| Hap | $55 - $67 | 411% |
| Caresource | $57 | 426% |
| Varipro | $57 | 426% |
| Cigna | $63 | 471% |
| 1199 National Benefit Fund | $64 | 478% |
| Allied National Global Care | $64 | 478% |
| Asrm - Reliance Standard Life Insurance | $64 | 478% |
| Christian Care Ministry | $64 | 478% |
| Dean Health | $64 | 478% |
| Fallon Health | $64 | 478% |
| Family Life Insurance Company | $64 | 478% |
| Ghc Scw | $64 | 478% |
| Group Pension Administrators | $64 | 478% |
| International Benefit Administrators | $64 | 478% |
| Lifetime Benefit Solutions | $64 | 478% |
| Manhattan Life | $64 | 478% |
| Medi Share | $64 | 478% |
| Multiplan | $64 | 478% |
| Mvp | $64 | 478% |
| Pai | $64 | 478% |
| Pan-American Life | $64 | 478% |
| Paramount Hmo | $64 | 478% |
| Phcs | $64 | 478% |
| Trinity Health Share | $64 | 478% |
| Acclaim | $66 | 493% |
| Administrative Concepts | $66 | 493% |
| Allegeant | $66 | 493% |
| Ameriben | $66 | 493% |
| American Family | $66 | 493% |
| American Healthcare Alliance | $66 | 493% |
| American Republic | $66 | 493% |
| Amerihealth | $66 | 493% |
| Aultcare | $66 | 493% |
| Automated Benefit Services | $66 | 493% |
| Auxiant | $66 | 493% |
| Benefit Administrative Systems,Llc | $66 | 493% |
| Boon Chapman | $66 | 493% |
| Cam Administrative Services | $66 | 493% |
| Christian Brother Services | $66 | 493% |
| Christian Brothers Holy Cross | $66 | 493% |
| Comprehensive Benefits | $66 | 493% |
| Continental Life Insurance | $66 | 493% |
| Custom Benefit Administrators | $66 | 493% |
| Employee Benefit Concepts | $66 | 493% |
| Employee Benefit Management | $66 | 493% |
| Enterprise Group Planning | $66 | 493% |
| Freedom Life Insurance Company | $66 | 493% |
| Group Administrators | $66 | 493% |
| Group Marketing Services | $66 | 493% |
| Guardian | $66 | 493% |
| Health America | $66 | 493% |
| Healthez | $66 | 493% |
| Humana | $66 - $87 | 493% |
| Insight | $66 | 493% |
| Intercare | $66 | 493% |
| Jfp Benefit Management | $66 | 493% |
| Jp Farley Corporation | $66 | 493% |
| Key Benefit Administrator | $66 | 493% |
| Liberty Union Life Assurance Co | $66 | 493% |
| Lucent Health | $66 | 493% |
| Luminare Health | $66 | 493% |
| Luminare Health (Detroit) | $66 | 493% |
| Medben | $66 | 493% |
| Medcost | $66 | 493% |
| Mutual Health Services | $66 | 493% |
| Mutual Of Omaha | $66 | 493% |
| Ncas | $66 | 493% |
| Nippon Life Ins | $66 | 493% |
| Nova | $66 | 493% |
| Painters Union Insurance Fund | $66 | 493% |
| Physicians Mutual | $66 | 493% |
| Plumbers Local 98 Insurance Fund | $66 | 493% |
| Prairie States | $66 | 493% |
| Primary Physician Care | $66 | 493% |
| Professional Benefit Administrators | $66 | 493% |
| The Loomis Company | $66 | 493% |
| Unicare | $66 | 493% |
| Us Health And Life | $66 | 493% |
| Valenz | $66 | 493% |
| Western & Southern Financial Group | $66 | 493% |
| Wps | $66 | 493% |
| Coventry | $69 | 515% |
| First Health | $69 | 515% |
| Priority Health | $77 - $79 | 575% |
| Cmh Allegan County | $87 | 650% |
| Cmh Ausable Valley | $87 | 650% |
| Cmh Barry County | $87 | 650% |
| Cmh Berrien County | $87 | 650% |
| Cmh Cass County | $87 | 650% |
| Cmh Clinton-Eaton-Ingham County | $87 | 650% |
| Cmh Kalamazoo | $87 | 650% |
| Cmh Kent County | $87 | 650% |
| Cmh Lenawee County | $87 | 650% |
| Cmh Misc | $87 | 650% |
| Cmh Monroe County | $87 | 650% |
| Cmh Montcalm County | $87 | 650% |
| Cmh Muskegon County | $87 | 650% |
| Cmh Newaygo County | $87 | 650% |
| Cmh North Country | $87 | 650% |
| Cmh Northern Lakes County | $87 | 650% |
| Cmh Ottawa County | $87 | 650% |
| Cmh Van Buren County | $87 | 650% |
| Cmh West Mi County | $87 | 650% |
| Magellan Behavioral Health | $87 | 650% |