CMS Price Transparency Data
Blood test, cholesterol (lipid panel)
Facility: Mercy Health Lakeshore Campus
Billing Code: 80061 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80061
- Insurance Median: $75
- Cash Discount Price: $57
- vs. Medicare Baseline: 5.60x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Mercy Health Lakeshore Campus is $75. 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 5.60x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$57
Average discount available for prompt cash payment at this facility.
Insurance Median
$75
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: $75 (560%)
Cash: $57 (426% of Medicare)
Ins. Median: $75 (560% 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 560% of the Medicare baseline (a markup of 460%). 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 | $10 - $74 | 75% |
| Medicaid / KanCare | $10 | 75% |
| Aetna | $13 - $69 | 97% |
| Blue Care Network Advantage | $13 | 97% |
| Medicare (plans) | $13 - $21 | 97% |
| Access Health | $15 | 112% |
| Wellpath | $21 | 157% |
| Align Senior Care | $22 | 164% |
| Correctional Recovery | $22 | 164% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $25 | 187% |
| U Of M Health Plan | $25 - $78 | 187% |
| Oscar | $27 | 202% |
| Vitalcore | $29 | 217% |
| UnitedHealthcare | $30 - $78 | 224% |
| Molina Marketplace | $36 | 269% |
| Hospice Of Michigan | $48 | 358% |
| Nomi Health | $49 | 366% |
| Hap | $65 - $78 | 485% |
| Geha | $69 - $78 | 515% |
| Meritain | $69 | 515% |
| Wc Accident Fund | $69 | 515% |
| Wc Advantage | $69 | 515% |
| Wc Aig | $69 | 515% |
| Wc Allied | $69 | 515% |
| Wc Amerisure | $69 | 515% |
| Wc Amtrust | $69 | 515% |
| Wc Asu Risk Mgt | $69 | 515% |
| Wc Berkley Admin | $69 | 515% |
| Wc Broadspire | $69 | 515% |
| Wc Bunch & Associates | $69 | 515% |
| Wc Ccmsi | $69 | 515% |
| Wc Emc Insurance Company | $69 | 515% |
| Wc Esis | $69 | 515% |
| Wc Fcci | $69 | 515% |
| Wc Federated | $69 | 515% |
| Wc Gallagher Bassett | $69 | 515% |
| Wc Genex Care For Ohio | $69 | 515% |
| Wc Guard Insurance Company | $69 | 515% |
| Wc Hartford | $69 | 515% |
| Wc Liberty Mutual | $69 | 515% |
| Wc Meijers | $69 | 515% |
| Wc Michigan | $69 | 515% |
| Wc Mitchell Frankenmuth | $69 | 515% |
| Wc Pma | $69 | 515% |
| Wc Sedgwick | $69 | 515% |
| Wc Sentry | $69 | 515% |
| Wc Travelers | $69 | 515% |
| Wc Tristar | $69 | 515% |
| Wc Walmart | $69 | 515% |
| Wc Zurich | $69 | 515% |
| Asr Health Benefits | $72 | 538% |
| Bcn Domestic | $74 | 553% |
| Blue Benefit Administrators Of Massachusetts | $74 | 553% |
| Blue Care Network | $74 | 553% |
| Blue Distinction Transplant | $74 | 553% |
| Blue Shield - Ca | $74 | 553% |
| Blue Shield - Id (Regence) | $74 | 553% |
| Blue Shield - Ny Highmark Northeastern | $74 | 553% |
| Blue Shield - Ny Highmark Western | $74 | 553% |
| Blue Shield - Pa (Highmark) | $74 | 553% |
| Blue Shield - Wa (Regence) | $74 | 553% |
| Health Choices | $74 - $78 | 553% |
| Kaiser Domestic | $74 | 553% |
| 1199 National Benefit Fund | $75 | 560% |
| Allied National Global Care | $75 | 560% |
| Asrm - Reliance Standard Life Insurance | $75 | 560% |
| Christian Care Ministry | $75 | 560% |
| Dean Health | $75 | 560% |
| Fallon Health | $75 | 560% |
| Family Life Insurance Company | $75 | 560% |
| Ghc Scw | $75 | 560% |
| Group Pension Administrators | $75 | 560% |
| International Benefit Administrators | $75 | 560% |
| Lifetime Benefit Solutions | $75 | 560% |
| Manhattan Life | $75 | 560% |
| Medi Share | $75 | 560% |
| Multiplan | $75 | 560% |
| Mvp | $75 | 560% |
| Pai | $75 | 560% |
| Pan-American Life | $75 | 560% |
| Paramount Hmo | $75 | 560% |
| Phcs | $75 | 560% |
| Trinity Health Share | $75 | 560% |
| Cigna | $76 | 568% |
| Acclaim | $78 | 583% |
| Administrative Concepts | $78 | 583% |
| Allegeant | $78 | 583% |
| Allied Benefit Systems | $78 | 583% |
| Ameriben | $78 | 583% |
| American Family | $78 | 583% |
| American Healthcare Alliance | $78 | 583% |
| American Republic | $78 | 583% |
| Amerihealth | $78 | 583% |
| Aultcare | $78 | 583% |
| Automated Benefit Services | $78 | 583% |
| Auxiant | $78 | 583% |
| Benefit Administrative Systems,Llc | $78 | 583% |
| Boon Chapman | $78 | 583% |
| Cam Administrative Services | $78 | 583% |
| Caresource | $78 | 583% |
| Christian Brother Services | $78 | 583% |
| Christian Brothers Holy Cross | $78 | 583% |
| Claimchoice Adminstrators | $78 | 583% |
| Comprehensive Benefits | $78 | 583% |
| Consociate | $78 | 583% |
| Continental Life Insurance | $78 | 583% |
| Custom Benefit Administrators | $78 | 583% |
| Cypress Benefit Administrators | $78 | 583% |
| Employee Benefit Concepts | $78 | 583% |
| Employee Benefit Management | $78 | 583% |
| Enterprise Group Planning | $78 | 583% |
| Forest County Potawatomi | $78 | 583% |
| Freedom Life Insurance Company | $78 | 583% |
| Group Administrators | $78 | 583% |
| Group Marketing Services | $78 | 583% |
| Guardian | $78 | 583% |
| Health America | $78 | 583% |
| Health Smart | $78 | 583% |
| Healthez | $78 | 583% |
| Healthgram | $78 | 583% |
| Healthscope | $78 | 583% |
| Humana | $78 | 583% |
| Insight | $78 | 583% |
| Intercare | $78 | 583% |
| Jfp Benefit Management | $78 | 583% |
| Jp Farley Corporation | $78 | 583% |
| Key Benefit Administrator | $78 | 583% |
| Liberty Union Life Assurance Co | $78 | 583% |
| Lucent Health | $78 | 583% |
| Luminare Health | $78 | 583% |
| Luminare Health (Detroit) | $78 | 583% |
| Medben | $78 | 583% |
| Medcost | $78 | 583% |
| Medical Mutual | $78 | 583% |
| Mutual Health Services | $78 | 583% |
| Mutual Of Omaha | $78 | 583% |
| Ncas | $78 | 583% |
| Nippon Life Ins | $78 | 583% |
| Nova | $78 | 583% |
| Painters Union Insurance Fund | $78 | 583% |
| Physicians Mutual | $78 | 583% |
| Plumbers Local 98 Insurance Fund | $78 | 583% |
| Prairie States | $78 | 583% |
| Primary Physician Care | $78 | 583% |
| Priority Health | $78 | 583% |
| Professional Benefit Administrators | $78 | 583% |
| Secureone Preferred United Plans | $78 | 583% |
| The Loomis Company | $78 | 583% |
| Trustmark Small Business Benefits | $78 | 583% |
| Unicare | $78 | 583% |
| Unified Group Services | $78 | 583% |
| Us Health And Life | $78 | 583% |
| Valenz | $78 | 583% |
| Varipro | $78 | 583% |
| Western & Southern Financial Group | $78 | 583% |
| Wps | $78 | 583% |
| First Health | $79 | 590% |