CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $26
Cash Discount Price: $86
vs. Medicare Baseline: 1.94x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Munson Healthcare Otsego Memorial Hospital is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.94x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$26

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: $86 (642%)

Insurance Median: $26 (194%)

Cash: $86 (642% of Medicare)

Ins. Median: $26 (194% 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.

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
UnitedHealthcare	$5 - $81	37%
Blue Cross Blue Shield	$7 - $63	52%
Mclaren Health Plan	$7 - $85	52%
Meridian	$7	52%
Molina	$7 - $14	52%
Priority Health	$7 - $30	52%
Aetna	$11 - $82	82%
Blue Care Network	$13	97%
Hap (Health Alliance Plan)	$13 - $81	97%
Humana	$13	97%
Medicare (plans)	$13	97%
Michigan Amish Medical Board	$13	97%
Northern Michigan Mennonite Group	$13	97%
Cigna	$14 - $30	105%
Employee Benefit Logistics	$23	172%
Hospice Of Michigan	$61	456%
Munson Hospice	$71 - $852	530%
Asr Physicians Care Network	$81	605%
Enterprise Group Planning/Employee Benefit Plan	$81	605%
Nomi Health	$81	605%
Cofinity	$86 - $91	642%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$86	642%
Three Rivers Provider Network	$86	642%

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 $86.
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 Munson Healthcare Otsego 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.