CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Boston Medical Center-Brighton

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $14
Cash Discount Price: $26
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Boston Medical Center-Brighton is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.05x the Medicare baseline. Located in 736 Cambridge Street, Nevins Building, Brighton, MA.

Cash / Self-Pay

$26

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $26 (194%)

Insurance Median: $14 (105%)

Cash: $26 (194% of Medicare)

Ins. Median: $14 (105% 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
Fallon Healthcre Aco [1121]	$12	90%
Hlth New England Aco [1123]	$12	90%
Mass General Brigham Health Plan Aco [1120]	$12	90%
Mass General Brigham Health Plan Mcd Mnged [1107]	$12	90%
Medicaid / KanCare	$12	90%
Tufts Together Aco [1122]	$12	90%
Tufts Together Mco [1125]	$12	90%
Wellsense Alli Aco [1118]	$12	90%
Wellsense Essential Mco [1101]	$12	90%
Aetna	$13 - $39	97%
Blue Cross Blue Shield	$13 - $33	97%
Humana	$13	97%
Medicare (plans)	$13 - $14	97%
Neighborhood Pace [1206]	$13	97%
Senior Whole Health [1210]	$13	97%
Ubh Hphc [8016]	$13	97%
United Community Plan [1202]	$13	97%
UnitedHealthcare	$13	97%
Veterans Admin [9003]	$13	97%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010]	$13	97%
Cca [1215]	$14	105%
Eternalhealth [1227]	$14	105%
Zzzcca Onecare [1216]	$14	105%
Cigna	$15 - $41	112%
Fallon [8008]	$17	127%
Unicare [8004]	$24	179%
Wellpoint [2034]	$24	179%
Tufts [8002]	$36 - $41	269%
Meritain Health [1023]	$39	291%
Mass General Brigham Health Plan Commercial [8009]	$43	321%
Mass General Brigham Health Plan Prime [7003]	$43	321%
Harvard Pilgrim Health Care [8001]	$49	366%
Hsn Bad Debt [4003]	$475	3547%
Hsn Confidential [4007]	$475	3547%
Hsn Dental [4006]	$475	3547%
Hsn Partial [4002]	$475	3547%
Hsn [4001]	$475	3547%

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 $26.
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 Boston Medical Center-Brighton 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.