CMS Price Transparency Data
Blood test, cholesterol (lipid panel)
Facility: Mercy Hospital Lincoln
Billing Code: 80061 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80061
- Insurance Median: $63
- Cash Discount Price: $91
- vs. Medicare Baseline: 4.71x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Mercy Hospital Lincoln is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 4.71x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.
Cash / Self-Pay
$91
Average discount available for prompt cash payment at this facility.
Insurance Median
$63
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: $91 (680%)
Insurance Median: $63 (471%)
Cash: $91 (680% of Medicare)
Ins. Median: $63 (471% 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 471% of the Medicare baseline (a markup of 371%). 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 |
|---|---|---|
| Medicaid / KanCare | $5 - $95 | 37% |
| Aetna | $11 - $135 | 82% |
| United Medical Resources Contracted [320454] | $13 | 97% |
| UnitedHealthcare | $13 - $48 | 97% |
| Blue Cross Blue Shield | $15 - $98 | 112% |
| Medicare (plans) | $16 - $206 | 119% |
| Tricare | $16 - $44 | 119% |
| American Health Advantage Of Mo Mcr [10473] | $17 - $48 | 127% |
| Cherokee Nation Health Serv Contracted [320066] | $17 - $48 | 127% |
| Cross Timbers Hospice [20098] | $17 - $48 | 127% |
| Dept Of Veteran Affairs Contracted [320106] | $17 - $48 | 127% |
| Elara Caring Aspire Hospice Contracted [320433] | $17 - $48 | 127% |
| Elara Caring Aspire Hospice [20433] | $17 - $48 | 127% |
| Globalhealth Contracted [320145] | $17 - $48 | 127% |
| Halo Hcr Inc Hospice Contracted [320432] | $17 - $48 | 127% |
| Halo Hcr Inc Hospice [20432] | $17 - $48 | 127% |
| Humana | $17 - $185 | 127% |
| Indian Health Service Contracted [320198] | $17 - $48 | 127% |
| Kindful Hospice Contracted [320434] | $17 - $48 | 127% |
| Kindful Hospice [20434] | $17 - $48 | 127% |
| Mercy Hospice Okc [20252] | $17 - $48 | 127% |
| Pace Of The Ozarks Contracted [320518] | $17 - $48 | 127% |
| Provider Partners Health Plans Contracted [320450] | $17 - $48 | 127% |
| Qual Choice Contracted [320325] | $17 - $48 | 127% |
| Cigna | $19 - $52 | 142% |
| Healthlink Contracted [320179] | $19 - $175 | 142% |
| Centivo Contracted [320505] | $27 - $75 | 202% |
| Medica Contracted [320239] | $31 - $87 | 232% |
| Ambetter / Centene | $34 - $95 | 254% |
| Home State Health Plan Contracted [320187] | $34 - $95 | 254% |
| Novasys Contracted [320285] | $34 - $95 | 254% |
| Hope Trust Contracted [320488] | $37 - $102 | 276% |
| Health Choices Contracted [320448] | $44 - $124 | 329% |
| Health Choices [20448] | $44 - $124 | 329% |
| Medical Associates Health Contracted [320444] | $44 - $124 | 329% |
| First Health Contracted [320128] | $48 - $154 | 358% |
| Mercy Mgd Behavioral Health Contracted [320259] | $56 - $154 | 418% |
| Multiplan Contracted [320270] | $56 - $154 | 418% |
| Private Health Care Systems Contracted [320320] | $56 - $154 | 418% |
| Workers Comp [20426] | $56 - $165 | 418% |
| Aither Health Contracted [320449] | $63 - $175 | 471% |
| Aither Health [20449] | $63 - $175 | 471% |
| Auxiant Contracted [320462] | $63 - $175 | 471% |
| Ebms Contracted [320493] | $63 - $175 | 471% |
| Edison Health Solutions Contracted [320502] | $63 - $175 | 471% |
| Federal Medical Center Contracted [320127] | $63 - $175 | 471% |
| Imagine 360 Contracted [320494] | $63 - $175 | 471% |
| Insurance System Inc Contracted [320465] | $63 - $175 | 471% |
| Mercy Benefit Admin Contracted [320251] | $63 - $175 | 471% |
| Mercy Benefit Admin [20251] | $63 - $175 | 471% |
| Point C Contracted [320238] | $63 - $175 | 471% |
| Preferred Health Plan Contracted [320522] | $63 - $175 | 471% |
| Reflect Health Contracted [320492] | $63 - $175 | 471% |
| Show-Me Health Administrators Contracted [320483] | $63 - $175 | 471% |
| Tri State Healthcare Coalition Contracted [320379] | $63 - $175 | 471% |
| Yuzu Health Contracted [320521] | $63 - $175 | 471% |