CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Crouse Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $26
Cash Discount Price: $67
vs. Medicare Baseline: 1.94x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Crouse Hospital is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $67. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.94x the Medicare baseline. Located in 736 Irving Avenue, Syracuse, NY.

Cash / Self-Pay

$67

Average discount available for prompt cash payment at this facility.

Insurance Median

$26

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: $67 (500%)

Insurance Median: $26 (194%)

Cash: $67 (500% of Medicare)

Ins. Median: $26 (194% 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.

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
Excellus	$14 - $29	105%
Aetna	$16 - $29	119%
Brighton Healthplan	$16 - $26	119%
Cdphp	$16	119%
Emblemhealth	$16	119%
Fidelis	$16 - $59	119%
Humana	$16	119%
Martins Point	$16	119%
Mvp	$16 - $59	119%
Nascentia	$16	119%
UnitedHealthcare	$16 - $27	119%
Mycompass	$17 - $27	127%
Wellcare	$17 - $31	127%
Healthfirst Health Plan	$26 - $29	194%
Molina	$26 - $59	194%
Emblem Health	$37	276%

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 $67.
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 Crouse 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.