CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Pender Memorial Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $110
Cash Discount Price: $80
vs. Medicare Baseline: 8.22x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Pender Memorial Hospital is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 8.22x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$110

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: $80 (597%)

Insurance Median: $110 (822%)

Cash: $80 (597% of Medicare)

Ins. Median: $110 (822% 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 822% of the Medicare baseline (a markup of 722%). 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
Humana	$46 - $153	344%
Blue Cross Blue Shield	$48 - $128	358%
Pace Of The Southern Piedmont	$48	358%
Aetna	$49 - $151	366%
New Hanover Health	$49	366%
Carolina Complete	$50	373%
Cigna	$50 - $78	373%
Nc Department Of Public Safety	$50 - $96	373%
Amerihealth	$51	381%
Wellcare	$51	381%
Ambetter / Centene	$67	500%
Liberty Health	$68	508%
Caresource North Carolina	$71	530%
Plotkin Health	$107	799%
UnitedHealthcare	$130	971%
Medcost	$134 - $149	1001%
Employers Choice Network	$173	1292%
Three Rivers Provider Network	$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 $80.
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 Pender Memorial 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.