CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Elizabethtown Community Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $143
Cash Discount Price: $247
vs. Medicare Baseline: 10.68x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Elizabethtown Community Hospital is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $247. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 10.68x the Medicare baseline. Located in 75 Park Street, Elizabethtown, NY.

Cash / Self-Pay

$247

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $247 (1845%)

Insurance Median: $143 (1068%)

Cash: $247 (1845% of Medicare)

Ins. Median: $143 (1068% 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 1068% of the Medicare baseline (a markup of 968%). 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
Capital District Physicians' Health Plan	$9 - $203	67%
Humana	$13	97%
Aetna	$94 - $161	702%
Blue Cross Blue Shield	$94 - $186	702%
Fidelis Care	$94	702%
Martins Point	$94	702%
Mvp	$94 - $193	702%
UnitedHealthcare	$94 - $227	702%
Veterans Affairs Community Care Network	$94	702%
Choicecare	$95 - $198	709%
Wellpath	$141	1053%
Emblem Health	$198	1479%
Harvard Pilgrim	$198	1479%
Magnacare	$198	1479%
Highmark Blueshield	$201	1501%
Coventry	$210	1568%
Multiplan	$222	1658%

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 $247.
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 Elizabethtown Community 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.