CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Saint Vincent Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $14
Cash Discount Price: $99
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Saint Vincent Hospital is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.05x the Medicare baseline. Located in 232 West 25Th Street, Erie, PA.

Cash / Self-Pay

$99

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $99 (739%)

Insurance Median: $14 (105%)

Cash: $99 (739% of Medicare)

Ins. Median: $14 (105% 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.

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
Highmark	$6 - $21	45%
Cigna	$10 - $14	75%
Univera	$11 - $16	82%
American Health Plans	$13	97%
Life Pittsburgh	$13	97%
Martin'S Point	$13 - $37	97%
UnitedHealthcare	$13 - $22	97%
University Of Pittsburgh Medical Center	$13 - $47	97%
Aetna	$14 - $27	105%
Amerihealth	$14	105%
Blue Cross Blue Shield	$14 - $21	105%
Highmark Wholecare	$14 - $19	105%
Humana	$14	105%
Jefferson Health Plans	$14 - $21	105%
Medical Mutual	$14	105%
Medicare (plans)	$14	105%
Molina	$15	112%
Pennsylvania Health And Wellness	$21	157%
Geisinger	$22	164%

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 $99.
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 Saint Vincent 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.