CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Adventist Health St Helena

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $19
  • Cash Discount Price: $29
  • vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Adventist Health St Helena is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.42x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.
Cash / Self-Pay
$29

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $29 (217%)
Insurance Median: $19 (142%)
Cash: $29 (217% of Medicare)
Ins. Median: $19 (142% 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.

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
Healthnet-All Plans $2 - $51 15%
Blue Shield Behav Hlth $5 - $171 37%
Blue Shield Epn-All Other Plans $5 - $179 37%
Blue Shield Non-Epn $5 - $176 37%
UnitedHealthcare $5 - $242 37%
Phcs-All Plans $6 - $208 45%
Western Growers-All Plans $6 - $201 45%
Choicecare-All Plans $8 - $265 60%
Interplan-All Plans $8 - $246 60%
Beech Street-All Plans $9 - $284 67%
Cigna $9 - $303 67%
Kaiser-All Other Plans $9 - $311 67%
Galaxy Network-All Plans $10 - $341 75%
Health Management Network-All Plans $10 - $322 75%
Three Rivers-All Plans $10 - $341 75%
Va Medi-Cal $12 - $15 90%
Blue Shield Bh Mcr Adv $13 97%
Blue Shield Mcr Adv $13 97%
Kaiser Mcr Adv $13 97%
Tricare $13 97%
Va Mcr - All Other Plans $13 97%
Ah Employee Health Plan - All Plans $24 179%
Aetna $78 583%
Blue Cross Blue Shield $116 - $155 866%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Woodland Road, Saint Helena, CA 94574
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals