CMS Price Transparency Data
Blood test, cholesterol (lipid panel)
Facility: John Muir Medical Center - Concord Campus
Billing Code: 80061 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80061
- Insurance Median: $16
- Cash Discount Price: $21
- vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at John Muir Medical Center - Concord Campus is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.19x the Medicare baseline. Located in 2540 East St, Concord, CA.
Cash / Self-Pay
$21
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: $21 (157%)
Insurance Median: $16 (119%)
Cash: $21 (157% 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.
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 |
|---|---|---|
| Carecentrix [1011001] | $11 - $26 | 82% |
| Generic Commercial/Indemnity [1017001] | $11 - $26 | 82% |
| Aps Healthcare [1003103] | $12 - $29 | 90% |
| Contra Costa County Jail [1012104] | $12 | 90% |
| Aetna | $13 - $47 | 97% |
| Alignment Health [1177113] | $13 | 97% |
| Blue Cross Blue Shield | $13 - $181 | 97% |
| Blue Shield-Network Mcare [1006127] | $13 | 97% |
| Care 1St Health Plan [1094113] | $13 | 97% |
| Caremore [1171113] | $13 | 97% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] | $13 | 97% |
| Easy Choice Health Plan [1083113] | $13 | 97% |
| Essence Healthcare [1049028] | $13 | 97% |
| Essence Healthcare [1049128] | $13 | 97% |
| Golden State-Network Mcare [1023127] | $13 | 97% |
| Health Net-Network Mcare [1028127] | $13 | 97% |
| Hospice Of East Bay [1085104] | $13 | 97% |
| Humana | $13 - $54 | 97% |
| Medicare (plans) | $13 - $52 | 97% |
| Scan-Network Mcare [1043127] | $13 | 97% |
| Tricare | $13 | 97% |
| United Behavioral Health [1048103] | $13 - $33 | 97% |
| UnitedHealthcare | $13 - $38 | 97% |
| Veterans Administration [1051113] | $13 | 97% |
| Cigna | $14 - $47 | 105% |
| Carelon Behavioral Health [1050104] | $15 - $36 | 112% |
| Fortified Provider Network [1063104] | $15 - $36 | 112% |
| Health Net Hmo [1028103] | $15 - $37 | 112% |
| Health Net-Network [1028026] | $15 - $37 | 112% |
| Jmpn Canopy Hn [1640000011] | $15 | 112% |
| Medigap [1036001] | $15 - $36 | 112% |
| Three Rivers Provider Network [1073104] | $15 - $36 | 112% |
| Blue Shield Hmo [1006103] | $16 - $41 | 119% |
| Contra Costa Health Plan Hmo [1013103] | $16 - $39 | 119% |
| Workers' Comp [1024005] | $16 | 119% |
| Blue Shield-Network [1006026] | $17 - $41 | 127% |
| Generic Hmo [1018103] | $17 | 127% |
| Generic Ppo [1021104] | $17 | 127% |
| Blue Shield Ppo [1006104] | $18 - $48 | 134% |
| Health Net Ppo [1028104] | $19 - $47 | 142% |
| Western Health Advantage Hmo [1053103] | $19 - $52 | 142% |
| Kaiser Hmo [1033103] | $20 - $48 | 149% |
| Federal Correction Institute [1062104] | $21 - $52 | 157% |
| First Health [1016104] | $21 - $55 | 157% |
| Healthsmart - Pka Interplan [1031104] | $21 - $52 | 157% |
| Networks By Design [1084104] | $21 - $52 | 157% |
| Pponext [1072104] | $21 - $52 | 157% |
| Sutter Preferred Health Plan [1044104] | $21 - $52 | 157% |
| Health Management Network [1066104] | $23 - $55 | 172% |
| Healthcomp [1089104] | $23 - $181 | 172% |
| Canopy Hn Hmo [1166103] | $24 | 179% |
| Galaxy Health Network [1064104] | $24 - $59 | 179% |
| Integrated Health Plan [1075104] | $24 - $59 | 179% |
| Brms [1091104] | $181 | 1352% |
| Delta Health Systems [1032104] | $181 | 1352% |
| Empire Plan [1092104] | $181 | 1352% |
| Donor Network West [1008103] | $4,000 | 29873% |