CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Grossmont Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $43
Cash Discount Price: $78
vs. Medicare Baseline: 3.21x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Grossmont Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.21x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $78 (583%)

Insurance Median: $43 (321%)

Cash: $78 (583% of Medicare)

Ins. Median: $43 (321% 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 321% of the Medicare baseline (a markup of 221%). 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
Blue Shield	$4 - $146	30%
Cigna	$4 - $121	30%
County Medical Services	$4 - $136	30%
Health Net	$4 - $146	30%
Indian Health Council	$4 - $116	30%
Aetna	$7 - $626	52%
Epic Americas	$7 - $93	52%
San Diego Pace	$7	52%
Blue Cross Blue Shield	$8 - $146	60%
Medi-Cal	$8	60%
Molina	$8 - $155	60%
UnitedHealthcare	$8 - $159	60%
Allianz Global Assistance	$9 - $93	67%
Interplan	$9 - $131	67%
Managed Health Network	$9 - $136	67%
Multiplan	$9 - $97	67%
Kaiser	$11	82%
Medicare (plans)	$29 - $175	217%
California Health And Wellness	$107 - $155	799%
Community Health Group	$136 - $159	1016%
Humana	$155	1158%

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 $78.
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 Grossmont 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.