CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Mercy Hospital Tishomingo Inc

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $80
  • Cash Discount Price: $105
  • vs. Medicare Baseline: 5.97x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Mercy Hospital Tishomingo Inc is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 5.97x the Medicare baseline. Located in 1000 South Byrd St, Tishomingo, OK.
Cash / Self-Pay
$105

Average discount available for prompt cash payment at this facility.

Insurance Median
$80

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: $105 (784%)
Insurance Median: $80 (597%)
Cash: $105 (784% of Medicare)
Ins. Median: $80 (597% 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 597% of the Medicare baseline (a markup of 497%). 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 - $107 90%
Humana $12 - $129 90%
Medicaid / KanCare $12 - $48 90%
Health Choice Contracted [320166] $18 134%
Blue Cross Blue Shield $43 - $77 321%
Ambetter / Centene $48 358%
Home State Health Plan Contracted [320187] $48 358%
Novasys Contracted [320285] $48 358%
Webtpa Contracted [320417] $68 508%
Medicare (plans) $74 - $103 553%
Cherokee Nation Health Serv Contracted [320066] $77 575%
Cross Timbers Hospice [20098] $77 575%
Dept Of Veteran Affairs Contracted [320106] $77 575%
Elara Caring Aspire Hospice Contracted [320433] $77 575%
Elara Caring Aspire Hospice [20433] $77 575%
Halo Hcr Inc Hospice Contracted [320432] $77 575%
Halo Hcr Inc Hospice [20432] $77 575%
Independent Health [20197] $77 575%
Indian Health Service Contracted [320198] $77 575%
Kindful Hospice Contracted [320434] $77 575%
Kindful Hospice [20434] $77 575%
Medical Associates Health [20444] $77 575%
Mercy Hospice Okc [20252] $77 575%
Provider Partners Health Plans Contracted [320450] $77 575%
Qual Choice Contracted [320325] $77 575%
Tribute Health Plan Mcr Contracted [320338] $77 575%
Tricare $77 575%
UnitedHealthcare $77 - $127 575%
Globalhealth Contracted [320145] $79 590%
Cigna $80 - $121 597%
Aither Health Contracted [320449] $97 - $137 724%
Mercy Benefit Admin Contracted [320251] $97 - $137 724%
Quik Trip Contracted [320447] $97 724%
Show-Me Health Administrators Contracted [320483] $97 724%
Medica Contracted [320239] $103 769%
First Health Contracted [320128] $107 799%
Osma Health Contracted [320292] $113 844%
Benefit Management Contracted [320052] $121 - $145 904%
Healthcare Highways Plus Contracted [320175] $121 904%
Private Health Care Systems Contracted [320320] $121 - $129 904%
United Medical Resources Contracted [320454] $127 948%
Multiplan Contracted [320270] $129 - $145 963%
Auxiant Contracted [320462] $137 1023%
Ebms Contracted [320493] $137 1023%
Healthlink Contracted [320179] $137 1023%
Imagine 360 Contracted [320494] $137 1023%
Preferred Community Choice Contracted [320311] $137 1023%
Reflect Health Contracted [320492] $137 1023%
Yuzu Health Contracted [320521] $137 1023%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 South Byrd St, Tishomingo, OK 73460
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals