CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Valley Children's Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $97
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 7.24x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Valley Children's Hospital is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 7.24x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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%)
Insurance Median: $97 (724%)
Ins. Median: $97 (724% 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 724% of the Medicare baseline (a markup of 624%). 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
Allcare Ipa $19 142%
Central California Alliance For Health $26 194%
Dignity Ipa_Formerly Img $27 202%
La Salle Ipa $27 202%
Sante Ipa $27 202%
Central Valley Medical Providers Ipa $28 - $88 209%
Kaiser $28 - $115 209%
Sequoia Health Ipa $28 209%
Univseral Healthcare Ipa $28 209%
United Physicians Network Ipa $29 217%
Community Care Ipa $30 224%
Adventist $33 246%
Blue Cross Blue Shield $34 - $133 254%
Cencal Health $38 284%
Kern Family Health Care $38 284%
Health Net $62 - $116 463%
UnitedHealthcare $80 597%
Dignity Health Central Coast $88 657%
Community Health $97 724%
Stanislaus Partners In Health $97 724%
Physicians Choice Medical Group $99 739%
Health Plan Of San Joaquin $106 792%
Fowler Packing $110 822%
Dignity (Formerly Managed Care Systems) $112 836%
Kern Legacy $115 859%
Blue Shield $118 - $134 881%
Aetna $119 889%
First Health Formerly Coventry $131 978%
Bakersfield Family Medical Group $133 993%
Network By Design $137 1023%
Community Care Health Plan $142 1060%
Health Smart $142 1060%
Key Medical Ipa $142 1060%
Sutter Health $150 1120%
Multiplan $169 1262%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens