CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Mercy Hospital - Cassville

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $146
Cash Discount Price: $118
vs. Medicare Baseline: 10.90x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Mercy Hospital - Cassville is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 10.90x the Medicare baseline. Located in 94 Main Street, Cassville, MO.

Cash / Self-Pay

$118

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $118 (881%)

Insurance Median: $146 (1090%)

Cash: $118 (881% of Medicare)

Ins. Median: $146 (1090% 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 1090% of the Medicare baseline (a markup of 990%). 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
Aetna	$12 - $162	90%
Humana	$12 - $155	90%
Medicaid / KanCare	$12 - $95	90%
Blue Cross Blue Shield	$13 - $177	97%
Medicare (plans)	$14 - $78	105%
UnitedHealthcare	$19 - $173	142%
Dept Of Veteran Affairs Contracted [320106]	$62	463%
Tricare	$74	553%
Cherokee Nation Health Serv Contracted [320066]	$75	560%
Cigna	$75 - $173	560%
Cross Timbers Hospice [20098]	$75	560%
Elara Caring Aspire Hospice [20433]	$75	560%
Globalhealth Contracted [320145]	$75	560%
Halo Hcr Inc Hospice Contracted [320432]	$75	560%
Halo Hcr Inc Hospice [20432]	$75	560%
Indian Health Service Contracted [320198]	$75	560%
Kindful Hospice Contracted [320434]	$75	560%
Kindful Hospice [20434]	$75	560%
Medical Associates Health Contracted [320444]	$75	560%
Mercy Hospice Okc [20252]	$75	560%
Mercy Mgd Behavioral Health Contracted [320259]	$75	560%
Pace Of The Ozarks Contracted [320518]	$75	560%
Provider Partners Health Plans Contracted [320450]	$75	560%
Qual Choice Contracted [320325]	$75	560%
Healthscope Contracted [320182]	$76	568%
Administrative Payor Contracted [320005]	$82	612%
Centivo Contracted [320505]	$93	695%
Ambetter / Centene	$95	709%
Home State Health Plan Contracted [320187]	$95	709%
Novasys Contracted [320285]	$95	709%
Healthlink Contracted [320179]	$118 - $164	881%
Preferred Health Plan Contracted [320522]	$118	881%
Health Systems Inc Contracted [320174]	$146	1090%
Insurance System Inc Contracted [320465]	$146	1090%
Point C Contracted [320238]	$146 - $164	1090%
Point C [20238]	$146	1090%
United Medical Resources Contracted [320454]	$146 - $155	1090%
Workers Comp [20426]	$146 - $164	1090%
Municipal Health Plan Contracted [320271]	$147	1098%
Medica Contracted [320239]	$163	1217%
90 Degree Benefits Contracted [320436]	$164	1225%
Aither Health Contracted [320449]	$164	1225%
American Healthcare Alliance Contracted [320020]	$164	1225%
Auxiant Contracted [320462]	$164	1225%
Benefit Management Contracted [320052]	$164	1225%
Ebms Contracted [320493]	$164	1225%
Edison Health Solutions Contracted [320502]	$164	1225%
Evolutions Health Care Contracted [320124]	$164	1225%
Imagine 360 Contracted [320494]	$164	1225%
Mercy Benefit Admin Contracted [320251]	$164	1225%
Reflect Health Contracted [320492]	$164	1225%
Show-Me Health Administrators Contracted [320483]	$164	1225%
Usa Managed Care Org Contracted [320429]	$164	1225%
Yuzu Health Contracted [320521]	$164	1225%
First Health Contracted [320128]	$173	1292%
Multiplan Contracted [320270]	$173	1292%
Private Health Care Systems Contracted [320320]	$173	1292%

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 $118.
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 Mercy Hospital - Cassville 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.