CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Mercy Hospital Ada

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $44
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 3.29x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Mercy Hospital Ada is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.29x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $84 (627%)
Insurance Median: $44 (329%)
Cash: $84 (627% of Medicare)
Ins. Median: $44 (329% 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 329% of the Medicare baseline (a markup of 229%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $12 - $138 90%
Humana $12 - $13 90%
Medicaid / KanCare $12 - $18 90%
Blue Cross Blue Shield $13 97%
Cherokee Nation Health Serv Contracted [320066] $13 97%
Cross Timbers Hospice [20098] $13 97%
Dept Of Veteran Affairs Contracted [320106] $13 97%
Elara Caring Aspire Hospice Contracted [320433] $13 97%
Elara Caring Aspire Hospice [20433] $13 97%
Globalhealth Contracted [320145] $13 97%
Halo Hcr Inc Hospice Contracted [320432] $13 97%
Halo Hcr Inc Hospice [20432] $13 97%
Independent Health [20197] $13 97%
Indian Health Service Contracted [320198] $13 97%
Kindful Hospice Contracted [320434] $13 97%
Kindful Hospice [20434] $13 97%
Medical Associates Health [20444] $13 97%
Medicare (plans) $13 - $184 97%
Mercy Hospice Okc [20252] $13 97%
Provider Partners Health Plans Contracted [320450] $13 97%
Qual Choice Contracted [320325] $13 97%
Tricare $13 97%
UnitedHealthcare $13 - $17 97%
Cigna $14 105%
United Medical Resources Contracted [320454] $17 - $110 127%
Ambetter / Centene $18 134%
Health Choice Contracted [320166] $18 134%
Home State Health Plan Contracted [320187] $18 134%
Medica Contracted [320239] $18 - $184 134%
Novasys Contracted [320285] $18 134%
Workers Comp [20426] $23 172%
Healthcare Highways Plus Contracted [320175] $29 - $138 217%
Healthsmart Preferred Care Contracted [320184] $30 224%
Kempton Contracted [320214] $30 224%
Webtpa Contracted [320417] $31 - $77 232%
Osma Health Contracted [320292] $33 - $83 246%
Benefit Management Contracted [320052] $37 - $120 276%
Aither Health Contracted [320449] $44 - $110 329%
Auxiant Contracted [320462] $44 - $110 329%
Ebms Contracted [320493] $44 - $110 329%
Federal Medical Center Contracted [320127] $44 - $110 329%
Healthlink Contracted [320179] $44 - $110 329%
Healthscope Contracted [320182] $44 - $110 329%
Imagine 360 Contracted [320494] $44 - $110 329%
Mercy Benefit Admin Contracted [320251] $44 - $120 329%
Point C Contracted [320238] $44 - $110 329%
Preferred Health Plan Contracted [320522] $44 - $110 329%
Quik Trip Contracted [320447] $44 - $110 329%
Reflect Health Contracted [320492] $44 - $110 329%
Show-Me Health Administrators Contracted [320483] $44 - $110 329%
Yuzu Health Contracted [320521] $44 - $110 329%
Globalhealth Contracted [320144] $47 - $116 351%
First Health Contracted [320128] $61 - $153 456%
Multiplan Contracted [320270] $63 - $156 471%
Private Health Care Systems Contracted [320320] $63 - $156 471%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 North Monte Vista, Ada, OK 74820
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals