CMS Price Transparency Data
Blood test, cholesterol (lipid panel)
Facility: Mercy Hospital Ardmore, Inc
Billing Code: 80061 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80061
- Insurance Median: $48
- Cash Discount Price: $88
- vs. Medicare Baseline: 3.58x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Mercy Hospital Ardmore, Inc is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.58x the Medicare baseline. Located in 1011 14Th Ave Nw, Ardmore, OK.
Cash / Self-Pay
$88
Average discount available for prompt cash payment at this facility.
Insurance Median
$48
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: $88 (657%)
Insurance Median: $48 (358%)
Cash: $88 (657% of Medicare)
Ins. Median: $48 (358% 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 358% of the Medicare baseline (a markup of 258%). 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.
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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 - $126 | 90% |
| Humana | $12 - $137 | 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 - $198 | 97% |
| Mercy Hospice Okc [20252] | $13 | 97% |
| Provider Partners Health Plans Contracted [320450] | $13 | 97% |
| Qual Choice Contracted [320325] | $13 | 97% |
| Tribute Health Plan Mcr Contracted [320338] | $13 | 97% |
| Tricare | $13 | 97% |
| UnitedHealthcare | $13 - $17 | 97% |
| Cigna | $14 - $22 | 105% |
| United Medical Resources Contracted [320454] | $17 - $129 | 127% |
| Ambetter / Centene | $18 | 134% |
| Health Choice Contracted [320166] | $18 | 134% |
| Home State Health Plan Contracted [320187] | $18 | 134% |
| Medica Contracted [320239] | $18 - $198 | 134% |
| Novasys Contracted [320285] | $18 | 134% |
| Community Care Contracted [320080] | $20 - $139 | 149% |
| Workers Comp [20426] | $23 | 172% |
| Healthcare Highways Plus Contracted [320175] | $29 - $119 | 217% |
| Healthsmart Preferred Care Contracted [320184] | $30 - $129 | 224% |
| Kempton Contracted [320214] | $30 | 224% |
| Webtpa Contracted [320417] | $31 - $83 | 232% |
| Osma Health Contracted [320292] | $33 - $89 | 246% |
| Aither Health Contracted [320449] | $44 - $119 | 329% |
| Auxiant Contracted [320462] | $44 - $129 | 329% |
| Benefit Management Contracted [320052] | $44 - $129 | 329% |
| Ebms Contracted [320493] | $44 - $119 | 329% |
| Healthlink Contracted [320179] | $44 - $129 | 329% |
| Imagine 360 Contracted [320494] | $44 - $119 | 329% |
| Mercy Benefit Admin Contracted [320251] | $44 - $129 | 329% |
| Quik Trip Contracted [320447] | $44 - $119 | 329% |
| Reflect Health Contracted [320492] | $44 - $119 | 329% |
| Show-Me Health Administrators Contracted [320483] | $44 - $119 | 329% |
| Yuzu Health Contracted [320521] | $44 - $119 | 329% |
| Federal Medical Center Contracted [320127] | $48 - $129 | 358% |
| Healthscope Contracted [320182] | $48 - $129 | 358% |
| Healthsmart Accel Contracted [320183] | $48 - $129 | 358% |
| Point C Contracted [320238] | $48 - $129 | 358% |
| Preferred Health Plan Contracted [320522] | $48 - $129 | 358% |
| Tri State Healthcare Coalition Contracted [320379] | $48 - $129 | 358% |
| First Health Contracted [320128] | $49 - $132 | 366% |
| Globalhealth Contracted [320144] | $50 - $135 | 373% |
| Preferred Community Choice Contracted [320311] | $56 - $150 | 418% |
| Private Health Care Systems Contracted [320320] | $56 - $158 | 418% |
| Multiplan Contracted [320270] | $59 - $178 | 441% |