CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Geisinger Wyoming Valley Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $52
Cash Discount Price: $160
vs. Medicare Baseline: 3.88x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Geisinger Wyoming Valley Medical Center is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.88x the Medicare baseline. Located in 1000 East Mountain Boulevard, Wilkes Barre, PA.

Cash / Self-Pay

$160

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $160 (1195%)

Insurance Median: $52 (388%)

Cash: $160 (1195% of Medicare)

Ins. Median: $52 (388% 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 388% of the Medicare baseline (a markup of 288%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Geisinger Health Plan	$13 - $41	97%
Humana	$13	97%
Life Geisinger	$13	97%
Medicare (plans)	$13 - $15	97%
Prison Health Services	$13	97%
Blue Cross Blue Shield	$14 - $60	105%
Geisinger Family Plan	$14	105%
Medicaid / KanCare	$14	105%
Amerihealth	$16	119%
Upmc For You	$16	119%
Health Partners	$17	127%
Upmc Chip	$18	134%
Ambetter / Centene	$44	329%
Cigna	$112 - $117	836%
Aetna	$120 - $172	896%
Christian Healthcare Ministries	$129	963%
UnitedHealthcare	$132	986%
Wyoming Seminary	$181	1352%
Intergroup Services	$219	1636%
Multiplan	$219	1636%

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 $160.
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 Geisinger Wyoming Valley Medical Center 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.