CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Childrens Hospital of Wisconsin

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $174
  • Cash Discount Price: $119
  • vs. Medicare Baseline: 12.99x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Childrens Hospital of Wisconsin is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 12.99x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$119

Average discount available for prompt cash payment at this facility.

Insurance Median
$174

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: $119 (889%)
Insurance Median: $174 (1299%)
Cash: $119 (889% of Medicare)
Ins. Median: $174 (1299% 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 1299% of the Medicare baseline (a markup of 1199%). 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
My Choice Wisconsin $13 - $15 97%
UnitedHealthcare $13 - $165 97%
Chorus Community Health Plan $14 105%
Blue Cross Blue Shield $15 - $206 112%
Managed Health Services $15 112%
Molina Healthcare Of Wisconsin $15 112%
Icare $17 127%
Froedtert Health $152 - $185 1135%
Medical College Of Wisconsin $152 1135%
Network Health Plan $155 1158%
Aspirus Health Plan $163 1217%
Common Ground Healthcare Cooperative $163 - $185 1217%
Trilogy Health Solutions $163 - $185 1217%
Wps Health Plan $165 - $196 1232%
Advocate Aurora Healthcare $167 1247%
Centivo $169 1262%
Health Partners $169 - $191 1262%
Employer Health Care Alliance Cooperative $171 1277%
Dean Health Plan $174 1299%
Group Health Cooperative Of Eau Claire $174 1299%
Oan Llc $174 1299%
Security Health Plan $180 1344%
Health Payment Systems $184 1374%
Praire States $185 1382%
Quartz Health Insurance $185 1382%
Sheboygan Employer'S Health Network $185 1382%
Mayo Clinic Health Solutions $189 1412%
Aetna $191 - $193 1426%
Bellin Thedacare $196 1464%
Cigna $196 1464%
Group Health Cooperative Of South Central Wisconsin $196 1464%
Prevea Health Network $196 1464%
Multiplan $198 - $206 1479%
Coventry Health Care $206 1538%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens