CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: San Antonio Regional Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $52
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 3.88x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at San Antonio Regional Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.88x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$185

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $185 (1382%)
Insurance Median: $52 (388%)
Cash: $185 (1382% of Medicare)
Ins. Median: $52 (388% 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 388% of the Medicare baseline (a markup of 288%). 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
UnitedHealthcare $7 - $201 52%
Ambetter / Centene $9 - $167 67%
Healthnet Medi-Cal $11 82%
Blue Shield Mcr Adv $13 97%
Caremore Mcr Adv - All Plans $13 97%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $13 97%
Healthnet Mcr Adv $13 97%
Humana $13 97%
Iehp Mcr Adv $13 97%
Inter Valley Hp Mcr Adv- All Plans $13 97%
Kindred Mcr Adv-All Plans $13 97%
Molina Mcr Adv $13 97%
Scan Health Plan Mcr Adv-All Plans $13 97%
Tricare $13 97%
Universal Care - All Plans $13 97%
Blue Cross Blue Shield $14 - $500 105%
Kasiser Mcr Adv $14 105%
Zelis Mcr Adv $14 105%
Imperial Health Mcr Adv-All Plans $15 112%
Medi-Cal $15 112%
Epic Health Plan - All Other Plans $16 - $276 119%
Kaiser Medi-Cal $16 119%
Alpha Care Mg Mcal/Hlthy Kids $17 127%
Choice Phycn Ntwrk Op Only $17 127%
Heritage Prov Ntwrk/Regal Mcal $17 127%
Molina Exchange-All Other Plans $17 127%
Aetna $18 - $920 134%
Molina Medi-Cal $18 134%
Blue Shield Hmo Pos / Calpers Ppo $19 - $340 142%
Iehp Comm - All Other Plans $19 142%
Iehp Mcal $20 149%
Redlands Employee $20 149%
Blue Shield Epo Ppo - All Other Plans $21 - $370 157%
Redlands Hmo-All Other Plans $21 157%
Prime Health - All Plans $23 172%
Pc Inland Valley Scan $26 - $460 194%
Pc Inland Valley-All Other Plans $26 - $460 194%
Coventry Ccn/First Hlth - All Plans $29 - $506 217%
Healthnet - All Other Plans $32 239%
Blue Shield Epn $37 276%
Choicecare Ntwrk-All Plans $37 - $662 276%
Kaiser Comm - All Other Plans $37 276%
Multiplan/Phcs - All Plans $37 - $662 276%
Networks By Design - All Plans $39 - $690 291%
Zelis Comm-All Other Plans $39 - $690 291%
Foundation Inland Epo-All Other Plans $42 - $736 314%
Foundation Inland Ppo $44 - $782 329%
Health Payors - All Plans $47 - $828 351%
Interplan - All Plans $47 - $828 351%
Cigna $49 366%
Wellcare/Easy Choice-All Plans $51 - $902 381%
Alpha Care Mg Mcr Adv $52 - $920 388%
Central Hlth Plan Mcr Adv-All Plans $52 - $920 388%
Epic Health Plan Mcr Adv $52 - $920 388%
Prospect Hp-All Plans $52 - $920 388%
Providence Clevercare Mcr Adv $52 - $920 388%
Heritage Prov Ntwrk/Regal Mcr Adv $53 - $934 396%
Clever Care Mcr Adv - All Plans $55 - $966 411%
La Salle Hp Mcr Adv-All Plans $55 - $966 411%
Providence Oscar-All Other Plans $55 - $966 411%
Alpha Care Mg-All Other Plans $65 - $1,150 485%
Heritage Prov Ntwrk/Regal - All Other Plans $96 - $1,690 717%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals