CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Lexington Memorial Hospital Inc

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $80
Cash Discount Price: $91
vs. Medicare Baseline: 5.97x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Lexington Memorial Hospital Inc is $80. 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 5.97x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $80 (597%)

Cash: $91 (680% of Medicare)

Ins. Median: $80 (597% 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 597% of the Medicare baseline (a markup of 497%). 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
Amerihealth	$24 - $27	179%
Carolina Complete	$24	179%
Healthy Blue	$24	179%
Partners	$24	179%
Alliance	$25	187%
Trillium	$25	187%
UnitedHealthcare	$25 - $81	187%
Vaya	$25	187%
Wellcare	$25	187%
Blue Cross Blue Shield	$26 - $43	194%
Ambetter / Centene	$28	209%
Medcost	$40 - $121	299%
Aetna	$51 - $167	381%
Oscar	$58 - $80	433%
Cigna	$79 - $80	590%
Directnet	$107	799%
Healthgram Lexington Home Brands	$130	971%
Healthgram	$145	1083%
Private Healthcare Systems	$148	1105%
Beechstreet	$159	1187%
Humana	$159	1187%
Multiplan	$163	1217%
National Provider Network	$163	1217%

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 $91.
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 Lexington Memorial Hospital Inc 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.