CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: North Carolina Baptist Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $95
Cash Discount Price: $142
vs. Medicare Baseline: 7.09x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at North Carolina Baptist Hospital is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 7.09x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$142

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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: $142 (1060%)

Insurance Median: $95 (709%)

Cash: $142 (1060% of Medicare)

Ins. Median: $95 (709% 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 709% of the Medicare baseline (a markup of 609%). 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	$13 - $248	97%
Apex	$13	97%
Blue Cross Blue Shield	$13 - $108	97%
Cigna	$13 - $175	97%
Devoted	$13	97%
Healthteam	$13	97%
UnitedHealthcare	$13 - $101	97%
Wellcare	$13 - $25	97%
Humana	$14 - $160	105%
Medicare (plans)	$14	105%
Liberty	$15	112%
Medcost	$20 - $194	149%
Amerihealth	$24 - $69	179%
Carolina Complete	$24	179%
Health Blue	$24	179%
Partners	$24	179%
Alliance	$25	187%
Trillium	$25	187%
Vaya	$25	187%
Ambetter / Centene	$62 - $66	463%
Oscar	$83 - $105	620%
Directnet	$163 - $173	1217%
Cone Health	$193 - $204	1441%
Healthgram	$193 - $204	1441%
First Carolina Care	$221 - $234	1650%
Private Healthcare Systems	$226 - $239	1688%
Multiplan	$248 - $263	1852%

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 $142.
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 North Carolina Baptist Hospital 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.