CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Sparrow Ionia Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $22
Cash Discount Price: $21
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Sparrow Ionia Hospital is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.64x the Medicare baseline. Located in 3565 S State Road, Ionia, MI.

Cash / Self-Pay

$21

Average discount available for prompt cash payment at this facility.

Insurance Median

$22

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: $21 (157%)

Insurance Median: $22 (164%)

Cash: $21 (157% of Medicare)

Ins. Median: $22 (164% 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
Blue Cross Blue Shield	$13 - $52	97%
Medicaid / KanCare	$13 - $15	97%
Priority Health Medihmo	$13	97%
Aetna	$14 - $21	105%
Covenant Advantage	$21	157%
Medicare (plans)	$21 - $22	157%
Medigold	$21	157%
Senior Community Care	$21	157%
Humana	$22 - $67	164%
Priority	$51	381%
UnitedHealthcare	$64	478%
Asr	$66	493%
Blue Care Network	$66	493%
Cigna	$66	493%
Great West Healthcare	$66	493%
Health Alliance Plan	$66	493%
Cofinity	$67	500%
Mclaren Commercial	$74	553%

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 $21.
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 Sparrow Ionia 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.