CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Fostoria Community Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $89
Cash Discount Price: $112
vs. Medicare Baseline: 6.65x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Fostoria Community Hospital is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 6.65x the Medicare baseline. Located in 501 Van Buren Street, Fostoria, OH.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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: $112 (836%)

Insurance Median: $89 (665%)

Cash: $112 (836% of Medicare)

Ins. Median: $89 (665% 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 665% of the Medicare baseline (a markup of 565%). 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
Meridian Health Plan Of Mi	$7	52%
Blue Cross Blue Shield	$13 - $111	97%
Health Alliance Plan	$13 - $129	97%
Health Value Management	$13 - $37	97%
Paramount Health Care	$13 - $91	97%
Buckeye Community Health Plan	$14 - $38	105%
Aetna	$15 - $115	112%
Buckeye Community Health Plan Inc	$15 - $62	112%
Dayton Area Health Plan Dba Caresource	$18 - $71	134%
UnitedHealthcare	$18 - $103	134%
Amerihealth	$30	224%
Veterans Affairs	$38	284%
Medical Mutual Of Ohio	$97 - $103	724%
Frontpath Health Coalition	$99	739%
Ohio Health Choice	$112	836%
Ohio Ppo Connect	$112 - $129	836%
Health Ohio Network	$136	1016%
Connecticut General Life Insurance Company	$137	1023%

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 $112.
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 Fostoria 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.