CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Aurora Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $111
Cash Discount Price: $109
vs. Medicare Baseline: 8.29x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Aurora Medical Center is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 8.29x the Medicare baseline. Located in 975 Port Washington Road, Grafton, WI.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $109 (814%)

Insurance Median: $111 (829%)

Cash: $109 (814% of Medicare)

Ins. Median: $111 (829% 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 829% of the Medicare baseline (a markup of 729%). 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
UnitedHealthcare	$11 - $210	82%
Aurora Caregiver	$13	97%
Blue Cross Blue Shield	$13 - $212	97%
Common Ground	$28 - $29	209%
Centivo	$29	217%
Aetna	$30 - $206	224%
Health Payment Systems	$33	246%
Quartz One	$33	246%
Healthpartners	$36 - $188	269%
Molina Exchange	$37	276%
Hs Technology	$38	284%
Cigna	$39 - $212	291%
Quartz Group	$39	291%
Everpointe Elite	$40	299%
Wisconsin Physician Service	$43 - $46	321%
Trilogy	$47	351%
Health Eos Plus	$111 - $150	829%
Health Eos	$148 - $200	1105%

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 $109.
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 Aurora 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.