CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Sanford Wheaton Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $107
  • Cash Discount Price: $102
  • vs. Medicare Baseline: 7.99x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Sanford Wheaton Medical Center is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 7.99x the Medicare baseline. Located in 401 12Th Street North, Wheaton, MN.
Cash / Self-Pay
$102

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $102 (762%)
Insurance Median: $107 (799%)
Cash: $102 (762% of Medicare)
Ins. Median: $107 (799% 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 799% of the Medicare baseline (a markup of 699%). 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
Blue Cross Blue Shield $47 - $94 351%
Sanford Health Plan Align $65 485%
Ucare $69 - $112 515%
Aetna $70 - $111 523%
Health Partners $70 - $104 523%
Medicare (plans) $70 523%
Security Health Plan $70 523%
UnitedHealthcare $70 - $107 523%
Primewest $71 - $77 530%
Sanford Health Plan $101 - $119 754%
Medica $113 - $121 844%
First Choice Health Network $115 859%
Healthez $115 859%
Multiplan $115 859%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 12Th Street North, Wheaton, MN 56296
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals