CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Cambridge Health Alliance

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $86
Cash Discount Price: $86
vs. Medicare Baseline: 6.42x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Cambridge Health Alliance is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 6.42x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $86 (642%)

Insurance Median: $86 (642%)

Cash: $86 (642% of Medicare)

Ins. Median: $86 (642% 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 642% of the Medicare baseline (a markup of 542%). 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
Boston Medical Center - Wellsense [50003]	$12	90%
Fallon [50006]	$12	90%
Mass Bh Partnership [70098]	$12	90%
Mass General Brigham [50021]	$12 - $55	90%
Mass Health [70001]	$12	90%
Medicaid / KanCare	$12	90%
Other Tufts Health Public Plan [75002]	$12 - $22	90%
Tufts Together W Cha [75001]	$12	90%
UnitedHealthcare	$12 - $48	90%
Medicare (plans)	$13 - $86	97%
Aarp [40001]	$18	134%
Oxford Health [40004]	$18	134%
United Medical Resource [40005]	$18	134%
Wc [90001]	$19	142%
Blue Cross Blue Shield	$26 - $86	194%
Wellpoint [50012]	$27	202%
Aetna	$36 - $86	269%
Cigna	$38 - $90	284%
Tufts Health Plan [30001]	$38 - $44	284%
Health Plans Inc [20002]	$48	358%
Hphc [20001]	$48	358%
Multiplan [50010]	$58	433%
Altus Dental [99011]	$86	642%
Beacon Health Strategies [50002]	$86	642%
Cbhc Uninsured Crisis Alt Payer [70097]	$86	642%
Cbhc Uninsured Crisis [70096]	$86	642%
Celticare [50004]	$86	642%
Commonwealth Care Alliance Dental [99004]	$86	642%
Coverage Discovery [90004]	$86	642%
Delta Dental Of Ma [99007]	$86	642%
Dominion National Dental [99012]	$86	642%
Dph Tb Payor [85004]	$86	642%
Esp Dental [99003]	$86	642%
Eyemed Alt Payor [13001]	$86	642%
First Health [50007]	$86	642%
Global Medical Management [50024]	$86	642%
Government Employee Health Association [50023]	$86	642%
Guardian Dental [99013]	$86	642%
Health Safety Net Dental [99002]	$86	642%
Humana	$86	642%
Ma Laborers Health And Welfare Fund [50022]	$86	642%
Magellan Health Services [65098]	$86	642%
Mass Health Dental [99001]	$86	642%
Medical Mutual Of Ohio [50019]	$86	642%
Metlife Dental [99008]	$86	642%
Modern Assistance Program [30098]	$86	642%
Mva [90002]	$86	642%
Neighborhood Health Plan [50011]	$86	642%
Other Bh Payor [50014]	$86	642%
Other Commercial Payor [50015]	$86	642%
Other Dental Payor [99014]	$86	642%
Other Dual Eligible Payer [65004]	$86	642%
Other Gov'T Alt [85006]	$86	642%
Other Vision Payor [50013]	$86	642%
Ri Neighborhood Health Plan [50017]	$86	642%
Tricare	$86	642%

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 $86.
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 Cambridge Health Alliance 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.