CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Adventist Health and Rideout

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $32
  • Cash Discount Price: $14
  • vs. Medicare Baseline: 2.39x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Adventist Health and Rideout is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.39x the Medicare baseline. Located in 726 4Th St, Marysville, CA.
Cash / Self-Pay
$14

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $14 (105%)
Insurance Median: $32 (239%)
Cash: $14 (105% of Medicare)
Ins. Median: $32 (239% 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 239% of the Medicare baseline (a markup of 139%). 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
Healthnet Mcal $2 - $68 15%
Bc Mcal $3 22%
Healthnet Comm-All Other Plans $7 - $204 52%
Aetna $8 - $241 60%
Blue Cross Blue Shield $9 - $263 67%
Blue Shield Uc Care Members $9 - $273 67%
Kaiser-All Other Plans $9 - $259 67%
UnitedHealthcare $9 - $296 67%
Cigna $10 - $291 75%
First Health-All Plans $10 - $298 75%
Interplan-All Plans $10 - $307 75%
Phcs-All Plans $10 - $300 75%
Blue Shield-All Other Plans $11 - $324 82%
Multiplan-All Plans $11 - $324 82%
Ca Health And Wellness- All Plans $12 - $19 90%
Celtic Mcaid-All Plans $12 - $19 90%
Kaiser Mcal $12 - $15 90%
Medi-Cal $12 - $15 90%
Partnership Hp Mcal -All Plans $12 - $15 90%
Kaiser Mcr Adv $13 97%
Tricare $13 97%
Ah Employee Health Plan - All Plans $24 179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 726 4Th St, Marysville, CA 95901
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Federal
  • Hospital Type: Acute Care Hospitals