CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: M Health Fairview Southdale Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $56
Cash Discount Price: $39
vs. Medicare Baseline: 4.18x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at M Health Fairview Southdale Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 4.18x the Medicare baseline. Located in 6401 France Avenue South, Edina, MN.

Cash / Self-Pay

$39

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

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: $39 (291%)

Insurance Median: $56 (418%)

Cash: $39 (291% of Medicare)

Ins. Median: $56 (418% 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 418% of the Medicare baseline (a markup of 318%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 - $40	97%
Itasca Medical Care	$13	97%
Medica	$13 - $36	97%
Primewest	$13	97%
Sanford Health Plan	$13 - $60	97%
Security Health Plan	$13 - $77	97%
South Country Health Alliance	$13	97%
Ucare	$13 - $30	97%
UnitedHealthcare	$13 - $26	97%
Wellcare	$13	97%
Health Partners	$14 - $118	105%
Hennepin Health	$14 - $15	105%
America'S Ppo	$49 - $74	366%
First Health	$78 - $84	583%
Multiplan	$80 - $87	597%
Private Healthcare Systems	$80 - $87	597%
Wisconsin Physician Services	$85 - $92	635%

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 $39.
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 M Health Fairview Southdale 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.