CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Southern Ocean Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $71
Cash Discount Price: $13
vs. Medicare Baseline: 5.30x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Southern Ocean Medical Center is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 5.30x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$13

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $13 (97%)

Insurance Median: $71 (530%)

Cash: $13 (97% of Medicare)

Ins. Median: $71 (530% 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 530% of the Medicare baseline (a markup of 430%). 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	$6 - $222	45%
Seoul Medical Group	$13	97%
Amerigroup	$13	97%
Clover	$13	97%
Wellcare	$13	97%
Vaccn	$13	97%
United Community/Americhoice	$14	105%
UnitedHealthcare	$16 - $29	119%
Karna	$17	127%
Oxford	$18 - $141	134%
Horizon	$21 - $238	157%
Bergen Risk	$25 - $195	187%
Brighton Health Plan	$26 - $208	194%
Cigna	$26 - $208	194%
Multiplan - PHCS	$28 - $221	209%
Amerihealth	$29 - $256	217%
Qualcare	$30 - $236	224%

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 $13.
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 Southern Ocean Medical Center 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.