CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Saint Mary's Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $28
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 2.09x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Saint Mary's Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.09x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $50 (373%)
Insurance Median: $28 (209%)
Cash: $50 (373% of Medicare)
Ins. Median: $28 (209% 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 209% of the Medicare baseline (a markup of 109%). 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
Blue Cross Blue Shield $12 - $15 90%
Geha $13 97%
Harvard Pilgrim Healthcare $13 97%
Connecticut Dept of Correction $13 97%
Aetna $13 - $24 97%
Medicare (plans) $13 - $14 97%
UnitedHealthcare $13 - $92 97%
Cca Senior Care Options $13 97%
Cigna $14 - $74 105%
Blue Shield - PA (Highmark) $15 112%
Kaiser Domestic $15 112%
Blue Shield - Wa (Regence) $15 112%
Blue Shield - Ny Highmark Western $15 112%
Unicare $15 112%
Blue Benefit Administrators of Massachusetts $15 112%
Pre-Employment $15 112%
Blue Shield - Id (Regence) $15 112%
Connecticare $15 112%
Bcn Domestic $15 112%
Blue Shield - Ny Highmark Northeastern $15 112%
Wc Domestic $15 112%
Blue Shield - Ca $15 112%
Blue Distinction Transplant $15 112%
Wellpoint $15 112%
Health Choices $15 112%
Blue Care Network $15 112%
Centivo $17 127%
Meritain $24 179%
Nippon Life Ins $24 179%
Hap $24 179%
Luminare Health $24 179%
Webtpa $24 179%
Allied Benefit Systems $24 179%
Gravie Admin Services $24 179%
1199 National Benefit Fund $24 179%
Magnacare $26 194%
Health Partners $26 194%
Allegiance $26 194%
Innovative Health Plan II $28 209%
Diversified Administrators $28 209%
Claimdoc $28 209%
Carelon Behavioral Health $45 - $46 336%
Health New England $48 - $49 358%
Medi Share $69 - $71 515%
Christian Care Ministry $69 - $71 515%
Dean Health $69 - $71 515%
Fallon Health $69 - $71 515%
Mvp $69 - $71 515%
Lifetime Benefit Solutions $69 - $71 515%
Multiplan $69 - $71 515%
International Benefit Administrators $69 - $71 515%
Pai $69 - $71 515%
PHCS $69 - $71 515%
Paramount HMO $69 - $71 515%
Pan-American Life $69 - $71 515%
Manhattan Life $69 - $71 515%
Trinity Health Share $69 - $71 515%
Ghc Scw $69 - $71 515%
Allied National Global Care $69 - $71 515%
Family Life Insurance Company $69 - $71 515%
Asrm - Reliance Standard Life Insurance $69 - $71 515%
Prime Health Services $72 - $74 538%
Health Smart $76 - $78 568%
United Behavioral Health Eap $90 - $92 672%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 56 Franklin Street, Waterbury, CT 06706
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals