CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Carilion Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $113
Cash Discount Price: $64
vs. Medicare Baseline: 8.44x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Carilion Medical Center is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 8.44x the Medicare baseline. Located in 1906 Belleview Avenue, Se, Roanoke, VA.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $64 (478%)

Insurance Median: $113 (844%)

Cash: $64 (478% of Medicare)

Ins. Median: $113 (844% 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 844% of the Medicare baseline (a markup of 744%). 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
Blue Cross Blue Shield	$14	105%
Sentara Health Plan	$14 - $113	105%
Abh Of Va (Formerly Coventry)	$15	112%
Abh Of Wva (Formerly Coventry)	$15	112%
Humana	$15	112%
UnitedHealthcare	$15 - $150	112%
Aetna	$93 - $122	695%
Gateway - Tier 3	$101	754%
Vhn - Ultra	$113	844%
Cigna	$123 - $132	919%
Connecticare	$128	956%
Vhn - Plus	$141	1053%
Gateway - Tier 2	$146	1090%
Vhn	$146	1090%
Vhn - Link	$165	1232%
Gateway - Tier 1	$174	1299%
Vhn - Secondary Payors	$174	1299%

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 $64.
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 Carilion 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.