CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $138
  • Cash Discount Price: $75
  • vs. Medicare Baseline: 10.31x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Carilion Stonewall Jackson Hospital is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 10.31x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.
Cash / Self-Pay
$75

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $75 (560%)
Insurance Median: $138 (1031%)
Cash: $75 (560% of Medicare)
Ins. Median: $138 (1031% 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 1031% of the Medicare baseline (a markup of 931%). 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 $14 105%
Sentara Health Plan $14 - $133 105%
Abh of VA (Formerly Coventry) $15 112%
Abh of Wva (Formerly Coventry) $15 112%
Humana $15 112%
UnitedHealthcare $15 - $176 112%
Aetna $109 - $143 814%
Gateway - Tier 3 $118 881%
Vhn - Ultra $133 993%
Connecticare $150 1120%
Cigna $172 1285%
Gateway - Tier 2 $172 1285%
Vhn - Plus $172 1285%
Integrated Health Plan $183 1367%
Vhn $183 1367%
Vhn - Link $194 1449%
Beech Street $198 1479%
Gateway - Tier 1 $204 1524%
Vhn - Secondary Payors $204 1524%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Health Circle, Lexington, VA 24450
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals