CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Mercy Hospital Joplin

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $27
  • Cash Discount Price: $151
  • vs. Medicare Baseline: 2.02x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Mercy Hospital Joplin is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.02x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.
Cash / Self-Pay
$151

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

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: $151 (1128%)
Insurance Median: $27 (202%)
Cash: $151 (1128% of Medicare)
Ins. Median: $27 (202% 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 202% of the Medicare baseline (a markup of 102%). 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 $11 - $169 82%
Aetna $12 - $16 90%
Humana $12 - $70 90%
Medicaid / KanCare $12 - $22 90%
Champva [20065] $13 97%
Cherokee Nation Health Serv Contracted [320066] $13 97%
Cigna $13 - $114 97%
Cross Timbers Hospice [20098] $13 97%
Dept Of Veteran Affairs Contracted [320106] $13 97%
Elara Caring Aspire Hospice [20433] $13 97%
Globalhealth Contracted [320145] $13 97%
Halo Hcr Inc Hospice Contracted [320432] $13 97%
Halo Hcr Inc Hospice [20432] $13 97%
Indian Health Service Contracted [320198] $13 - $151 97%
Kindful Hospice Contracted [320434] $13 97%
Kindful Hospice [20434] $13 97%
Medica Contracted [320239] $13 97%
Medicare (plans) $13 - $14 97%
Mercy Hospice Okc [20252] $13 97%
Mercy Mgd Behavioral Health Contracted [320259] $13 97%
Pace Of The Ozarks Contracted [320518] $13 97%
Provider Partners Health Plans Contracted [320450] $13 97%
Qual Choice Contracted [320325] $13 97%
Tricare $13 97%
United Medical Resources Contracted [320454] $13 - $47 97%
UnitedHealthcare $13 - $18 97%
Healthscope Contracted [320182] $16 119%
Health Choice Contracted [320166] $17 127%
Ambetter / Centene $22 164%
Centivo Contracted [320505] $22 164%
Home State Health Plan Contracted [320187] $22 164%
Novasys Contracted [320285] $22 164%
Providrs Care Network Contracted [320484] $25 187%
Aither Health Contracted [320449] $27 - $132 202%
Auxiant Contracted [320462] $27 - $151 202%
Ebms Contracted [320493] $27 202%
Healthlink Contracted [320179] $27 - $151 202%
Imagine 360 Contracted [320494] $27 202%
Mercy Benefit Admin Contracted [320251] $27 - $132 202%
Reflect Health Contracted [320492] $27 202%
Yuzu Health Contracted [320521] $27 202%
90 Degree Benefits Contracted [320436] $78 583%
Show-Me Health Administrators Contracted [320483] $78 - $82 583%
Point C Contracted [320238] $81 - $186 605%
Benefit Management Contracted [320052] $100 747%
Health Systems Inc Contracted [320174] $100 747%
Insurance System Inc Contracted [320465] $100 747%
Administrative Payor Contracted [320005] $104 777%
Edison Health Solutions Contracted [320502] $132 986%
Preferred Health Plan Contracted [320522] $151 1128%
First Health Contracted [320128] $158 1180%
American Healthcare Alliance Contracted [320020] $162 1210%
Multiplan Contracted [320270] $179 1337%
Private Health Care Systems Contracted [320320] $179 1337%
Usable Contracted [320409] $179 1337%
Point C [20238] $186 1389%
Workers Comp [20426] $186 - $232 1389%
Usa Managed Care Org Contracted [320429] $204 1524%
Ppo Plus Contracted [320310] $209 1561%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Mercy Way, Joplin, MO 64804
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals