CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Fort Memorial Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $122
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 9.11x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Fort Memorial Hospital is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 9.11x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $66 (493%)
Insurance Median: $122 (911%)
Cash: $66 (493% of Medicare)
Ins. Median: $122 (911% 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 911% of the Medicare baseline (a markup of 811%). 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 $3 - $139 22%
Dean Health Plan $3 - $139 22%
Managed Health Services $3 22%
Medicaid / KanCare $3 22%
Quartz $3 - $150 22%
UnitedHealthcare $3 - $160 22%
Molina $11 82%
Humana $13 - $151 97%
Centivo $16 - $17 119%
Veteran Evaluation Services $17 127%
Aetna $80 - $159 597%
Group Health Cooperative $128 - $251 956%
Alliance $142 - $152 1060%
Mercycare $147 - $158 1098%
Trilogy $174 - $186 1299%
Cigna $188 - $201 1404%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 Sherman Ave E, Fort Atkinson, WI 53538
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals