CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Atrium Health Cleveland

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $154
Cash Discount Price: $188
vs. Medicare Baseline: 11.50x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Atrium Health Cleveland is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $188. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 11.50x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$188

Average discount available for prompt cash payment at this facility.

Insurance Median

$154

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: $188 (1404%)

Insurance Median: $154 (1150%)

Cash: $188 (1404% of Medicare)

Ins. Median: $154 (1150% 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 1150% of the Medicare baseline (a markup of 1050%). 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	$14 - $289	105%
Blue Cross Blue Shield	$14 - $154	105%
Choicecare	$14 - $308	105%
Cigna	$14 - $300	105%
Humana	$14	105%
UnitedHealthcare	$14 - $200	105%
Alliance	$17 - $63	127%
Amerihealth Caritas	$17 - $53	127%
Carolina Complete Health	$17 - $54	127%
Healthy Blue	$17 - $54	127%
Partners	$17 - $53	127%
Trillium	$17 - $56	127%
Vaya	$17 - $55	127%
Wellcare	$17 - $54	127%
Medcost	$30 - $249	224%
Ambetter / Centene	$120 - $136	896%
Employers Health Network	$166 - $199	1240%
Physician Reach Out	$188	1404%
Magellan	$225	1680%
Gmmi	$244	1822%
Quik Trip	$244	1822%
Carolina Behavioral Health	$270 - $300	2016%
Healthgram	$300	2240%
First Health	$319	2382%
Lifesynch Community Choice Care	$319	2382%
Private Health Care Systems	$338	2524%
Beechstreet	$345	2577%
Multiplan	$357	2666%

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 $188.
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 Atrium Health Cleveland 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.