CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: City of Hope National Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $82
Cash Discount Price: $115
vs. Medicare Baseline: 6.12x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at City of Hope National Medical Center is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 6.12x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$115

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

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: $115 (859%)

Insurance Median: $82 (612%)

Cash: $115 (859% of Medicare)

Ins. Median: $82 (612% 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 612% of the Medicare baseline (a markup of 512%). 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 Cross Blue Shield	$2 - $134	15%
Heritage Provider Network	$2 - $120	15%
Blue Shield	$3 - $221	22%
Blue Shield Covca	$3 - $104	22%
UnitedHealthcare	$3 - $96	22%
Blue Shield Promise	$4 - $120	30%
Cencal	$4 - $137	30%
Inland Empire	$4 - $137	30%
Kaiser	$4 - $154	30%
La Care Health	$4 - $137	30%
Aetna	$5 - $171	37%
Cigna	$5 - $184	37%
Gold Coast	$5 - $171	37%
Health Net	$5 - $166	37%
Molina	$5 - $222	37%
Prime Healthcare Keenan	$5 - $164	37%
Healthcare Partners	$6 - $198	45%
Primecare Medical Network	$6 - $222	45%
St. Joseph Heritage	$6 - $205	45%
First Health	$8 - $263	60%
Phcs Multiplan	$9 - $308	67%
Cal Optima	$10 - $16	75%
Facey	$10 - $17	75%

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 $115.
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 City of Hope National Medical Center 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.