CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $35
Cash Discount Price: $128
vs. Medicare Baseline: 2.61x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at UMass Memorial Healthalliance Hospitals is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.61x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$128

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

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: $128 (956%)

Insurance Median: $35 (261%)

Cash: $128 (956% of Medicare)

Ins. Median: $35 (261% 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 261% of the Medicare baseline (a markup of 161%). 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
Institution [10406]	$12 - $70	90%
Masshealth [20302]	$12	90%
Medicaid / KanCare	$12 - $15	90%
Cigna	$13 - $50	97%
Medicare (plans)	$13	97%
Tufts Dual [10111]	$13	97%
Tufts Us Family [11203]	$13	97%
Aetna	$14 - $87	105%
Blue Cross Blue Shield	$14 - $46	105%
Commonwealth Care Mcr [10115]	$14	105%
Fallon Mcr Supp [20202]	$14	105%
Harvard Pilgrim Mcr [10106]	$14	105%
Mgb Mcr [10124]	$14	105%
Senior Whole Health [10110]	$14	105%
Tufts Mcr [10112]	$14	105%
UnitedHealthcare	$14 - $133	105%
Champva [11001]	$15	112%
Correctional Care [11003]	$18 - $21	134%
Workers Compensation [20501]	$19	142%
Tufts Connectorcare [10507]	$23	172%
Tufts [11201]	$29	217%
Harvard Pilgrim [10701]	$34 - $41	254%
Wellpoint [11112]	$35	261%
Hne [11108]	$69 - $74	515%
First Health Network [11120]	$92 - $100	687%
Multiplan [11109]	$92 - $100	687%
Fallon Connectorcare [10503]	$97	724%
Connecticare [11105]	$123 - $133	919%
Fallon Carelon Hlth [28]	$123 - $133	919%
Fallon Mcaid Carelon Hlth [29]	$123 - $133	919%
Grants [20507]	$123 - $133	919%
Hsno/Free Care [10801]	$294	2196%

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 $128.
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 UMass Memorial Healthalliance Hospitals 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.