CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: North Austin Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $58
  • Cash Discount Price: $707
  • vs. Medicare Baseline: 4.33x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at North Austin Medical Center is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $707. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 4.33x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$707

Average discount available for prompt cash payment at this facility.

Insurance Median
$58

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: $707 (5280%)
Insurance Median: $58 (433%)
Cash: $707 (5280% of Medicare)
Ins. Median: $58 (433% 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 433% of the Medicare baseline (a markup of 333%). 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
Blue Cross Blue Shield $8 - $358 60%
Molina Healthcare $8 - $15 60%
St David’S Hospice $8 - $13 60%
United $8 - $546 60%
Aetna $10 - $14 75%
Humana $10 - $13 75%
Sendero $10 - $23 75%
Superior Health Plan $10 - $206 75%
Cigna $13 - $38 97%
Devoted Health $13 97%
Odyssey Hospice $13 97%
Triwest Healthcare Alliance $13 97%
UnitedHealthcare $13 - $546 97%
Wellmed $13 97%
American Health Plan Of Texas $14 105%
Provider Partners Health Plan $14 105%
Pyramid Life $14 105%
Shared Health $14 105%
Texas Independent Health Plan $14 105%
Wellcare $14 105%
Imperial Insurance $15 112%
Triwest Health Alliance $15 112%
Universal Health $16 119%
Austin Fc $17 127%
Amerigroup $18 134%
Naphcare $21 157%
Seven Corners $21 157%
Corvel Corporation $27 202%
Oscar $37 - $41 276%
Moda $47 - $285 351%
Covenant Management Systems $58 - $349 433%
Healthcare Highways $58 - $364 433%
Imo Med - Select Network $60 - $364 448%
Nomi Health $64 - $449 478%
Moda Health $72 - $449 538%
Evry Health $74 - $446 553%
Texas Healthcare Foundation Heb $74 - $449 553%
Texas Workforce Commission $78 - $473 583%
Harbor Health Team $80 - $485 597%
Averde Health $90 - $546 672%
Comanche County $100 - $606 747%
National Choicecare $100 - $606 747%
Healthsmart Preferred Care $110 - $970 822%
Independent Medical Systems $110 - $667 822%
Physicians Cooperative Of Texas $110 - $667 822%
Prime Health $120 - $728 896%
First Health $125 - $861 934%
Coastal Comp Health Networks $130 - $788 971%
National Health Care $130 - $788 971%
Texas Municipal League $140 - $849 1046%
Medcorp Southwest $150 - $910 1120%
Rockport Healthcare Group $160 - $1,092 1195%
Bce Emergis Corporation $180 - $1,092 1344%
Beech Street $180 - $1,092 1344%
Medical Control Network Solutions $180 - $1,092 1344%
Multiplan $180 - $1,092 1344%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals