CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Adventist Health Tulare

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $19
Cash Discount Price: $51
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Adventist Health Tulare is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.42x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$19

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: $51 (381%)

Insurance Median: $19 (142%)

Cash: $51 (381% of Medicare)

Ins. Median: $19 (142% 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.

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	$3 - $137	22%
Blue Shield Epn	$4 - $176	30%
Blue Shield-All Other Plans	$5 - $243	37%
Cigna	$5 - $257	37%
Western Growers - All Plans	$5 - $256	37%
Hs Interplan-All Plans	$8 - $373	60%
Network By Design-All Plans	$8 - $361	60%
UnitedHealthcare	$8 - $403	60%
Multiplan - All Plans	$10 - $473	75%
Ccipa Medi-Cal - All Plans	$12 - $20	90%
Dignity Mcal Op Only	$12 - $17	90%
Healthnet Medi-Cal	$12 - $20	90%
Independence Op Only - All Plans	$12 - $17	90%
Medi-Cal	$12 - $15	90%
Blue Shield Mcare	$13	97%
Dignity Mcr Op Only - All Other Plans	$13	97%
Fhcn Pace Mcr Adv - All Plans	$13	97%
Medicare (plans)	$13	97%
Prime Health - All Plans	$13	97%
Tricare	$13	97%
Cal Forensic Med Grp - All Plans	$17	127%
Prison Hlthcre - All Plans	$17	127%
Bright Health - All Plans	$19	142%
Ah Employee Health Plan - All Plans	$24	179%
Incentive Hlth - All Plans	$24	179%
Healthnet Hmo/Ppo - All Other Plans	$36	269%
Aetna	$116	866%

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 $51.
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 Adventist Health Tulare 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.