CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: UPMC Hanover

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $28
  • Cash Discount Price: $88
  • vs. Medicare Baseline: 2.09x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at UPMC Hanover is $28. 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 2.09x the Medicare baseline. Located in 300 Highland Ave, Hanover, PA.
Cash / Self-Pay
$88

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $28 (209%)
Cash: $88 (657% of Medicare)
Ins. Median: $28 (209% 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 209% of the Medicare baseline (a markup of 109%). 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 $13 - $14 97%
Blue Cross Blue Shield $13 - $99 97%
Humana $13 97%
Amerihealth Caritas $14 105%
Cigna $14 - $35 105%
Geisinger $14 - $105 105%
Pa Health & Wellness $14 - $24 105%
UnitedHealthcare $14 - $71 105%
Upmc Work Partners $14 105%
Highmark Wholecare (Prev Gateway) $18 134%
Upmc Health Plan $18 - $102 134%
Health Partners Plans (Jefferson Health Plan) $19 142%
Keystone Autism Services $21 157%
Keystone Health Plan $28 - $99 209%
Prime Net $35 - $46 261%
Carefirst $124 926%
Multiplan $124 926%
Wellspan Population Health $127 948%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Highland Ave, Hanover, PA 17331
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals