CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Riverside Community Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $16
Cash Discount Price: $1,262
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Riverside Community Hospital is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,262. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.19x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.

Cash / Self-Pay

$1,262

Average discount available for prompt cash payment at this facility.

Insurance Median

$16

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: $1,262 (9425%)

Insurance Median: $16 (119%)

Cash: $1,262 (9425% of Medicare)

Ins. Median: $16 (119% 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.

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
Bristol Hospice	$11	82%
Aetna	$13 - $227	97%
Alignment Health Plan	$13	97%
Blue Cross Blue Shield	$13 - $70	97%
Blue Shield	$13 - $147	97%
Brand New Day	$13 - $16	97%
Central Health Plan	$13	97%
Clever Care Of Golden State	$13	97%
Easy Choice Health Plan	$13	97%
Heritage Provider Network	$13 - $18	97%
Humana	$13	97%
Redlands Community Hospital	$13	97%
Riverside Medical Clinic	$13 - $16	97%
Riverside Physician	$13	97%
Scan Health Plan	$13	97%
Triwest Healthcare Alliance	$13	97%
United	$13 - $332	97%
UnitedHealthcare	$13	97%
Care1St Health Plan	$14	105%
Health Net	$14 - $281	105%
La Care Health	$15	112%
Molina	$15	112%
Corvel Corporation	$16	119%
Healthsmart	$16 - $1,009	119%
Next	$16 - $1,009	119%
Inland Empire Health Plan	$22 - $23	164%
Bright Health	$33	246%
Cigna	$37	276%
Medcare Partners	$189	1412%
First Health	$555 - $1,136	4145%
American Health System	$568	4242%
Multiplan	$1,009 - $1,072	7535%

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 $1,262.
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 Riverside Community Hospital 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.