CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Essentia Health St Mary's Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $66
  • Cash Discount Price: $97
  • vs. Medicare Baseline: 4.93x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Essentia Health St Mary's Medical Center is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 4.93x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$97

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $97 (724%)
Insurance Median: $66 (493%)
Cash: $97 (724% of Medicare)
Ins. Median: $66 (493% 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 493% of the Medicare baseline (a markup of 393%). 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
Advocare/Security Health $13 97%
Blue Cross Blue Shield $13 - $112 97%
Freedom Blue Ppo $13 97%
Healthpartners Care Msho / Mcr Adv $13 97%
Imcare Msho (Ref Req) $13 97%
Imcare Msho Pcc Prime $13 97%
Imcare Msho Ref Req $13 97%
Itasca Med Care $13 97%
Medica Advantage Solutions $13 97%
Medica Msho/Dual Solutions $13 97%
Medica Prime Solution Group $13 97%
Medicare (plans) $13 97%
Nd Va Administration $13 97%
Platinum Blue / Vantage Blue $13 97%
Primewest $13 97%
Primewest Msho $13 97%
Secure Blue Msho $13 97%
Ubh Cost Plan $13 97%
Ubh Msho $13 97%
Ucare Msho $13 97%
UnitedHealthcare $13 - $108 97%
Sanford Health Plan $43 - $66 321%
Medica Access $49 366%
Healthpartners Care Pmap $59 441%
Blue Plus Pmap Pcc Prime $65 - $74 485%
Medica $81 - $84 605%
Medica Uplan $81 605%
Healthpartners $88 - $105 657%
Medica Choice $90 672%
Ucare $97 724%
Cigna $105 784%
Healthpartners Pcc Prime $105 784%
Wea $106 - $113 792%
Security Health $113 844%
America'S Ppo $114 851%
Wps $122 - $123 911%
Aetna $125 934%
Healthscope Benefits $125 934%
Healtheos $126 941%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals