CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: UPMC Muncy

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $195
Cash Discount Price: $228
vs. Medicare Baseline: 14.56x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at UPMC Muncy is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 14.56x the Medicare baseline. Located in 215 East Water Street, Muncy, PA.

Cash / Self-Pay

$228

Average discount available for prompt cash payment at this facility.

Insurance Median

$195

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: $228 (1703%)

Insurance Median: $195 (1456%)

Cash: $228 (1703% of Medicare)

Ins. Median: $195 (1456% 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 1456% of the Medicare baseline (a markup of 1356%). 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
Upmc Work Partners	$13	97%
Three Rivers Provider Network	$14 - $342	105%
Geisinger	$15 - $255	112%
Upmc Health Plan	$15 - $166	112%
Amerihealth Caritas	$16 - $2,208	119%
Highmark Wholecare (Prev Gateway)	$16 - $57	119%
UnitedHealthcare	$18 - $260	134%
Pa Health & Wellness	$24 - $2,316	179%
Cigna	$60 - $260	448%
Aetna	$116 - $251	866%
Coventry/First Health	$144 - $256	1075%
Blue Cross Blue Shield	$149 - $176	1113%
Wirerope Works	$211	1576%
Multiplan	$296 - $361	2211%
America'S Choice	$304	2270%
Intergroup	$304	2270%

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 $228.
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 UPMC Muncy 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.