CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Unitypoint Health - Meriter

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $81
  • Cash Discount Price: $232
  • vs. Medicare Baseline: 6.05x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Unitypoint Health - Meriter is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $232. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 6.05x the Medicare baseline. Located in 202 S Park St, Madison, WI.
Cash / Self-Pay
$232

Average discount available for prompt cash payment at this facility.

Insurance Median
$81

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: $232 (1733%)
Insurance Median: $81 (605%)
Cash: $232 (1733% of Medicare)
Ins. Median: $81 (605% 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 605% of the Medicare baseline (a markup of 505%). 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
UnitedHealthcare $8 - $120 60%
Aspirus $13 - $174 97%
Blue Cross Blue Shield $13 - $275 97%
Humana $13 97%
Illinicare $13 97%
Meridiancare $13 97%
Prevea 360 $13 - $246 97%
Wellmark Uph Self-Funded $13 - $167 97%
Health Partners Open Network $21 - $106 157%
Cigna $61 - $87 456%
Security Health Plan $66 - $90 493%
Mercy Care $77 - $96 575%
Medical Associates Health Plan $81 - $104 605%
Quartz $90 672%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 202 S Park St, Madison, WI 53715
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals