CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Boston Children's Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $165
Cash Discount Price: $233
vs. Medicare Baseline: 12.32x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Boston Children's Hospital is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $233. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 12.32x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$233

Average discount available for prompt cash payment at this facility.

Insurance Median

$165

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: $233 (1740%)

Insurance Median: $165 (1232%)

Cash: $233 (1740% of Medicare)

Ins. Median: $165 (1232% 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 1232% of the Medicare baseline (a markup of 1132%). 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
Blue Cross Blue Shield	$47 - $154	351%
Unicare	$53	396%
Cdphp	$114 - $198	851%
Harvard Pilgrim	$118 - $157	881%
United	$139 - $195	1038%
Aetna	$140 - $195	1046%
Mgb/Allways	$142 - $172	1060%
Tufts Public Plan	$143	1068%
Ambetter / Centene	$147	1098%
United Ri Nj Ny	$147	1098%
Carelon Strategies/Bhs	$151	1128%
UnitedHealthcare	$151 - $198	1128%
Carelon/Beacon	$175	1307%
Fallon	$178 - $180	1329%
Health New England	$188	1404%
Cigna	$198 - $210	1479%
Ets/Lifetrac	$198	1479%
Interlink Transplant	$198	1479%
Community Health Options	$210	1568%
Humana	$210	1568%
Coventry/Hcvm/First Health	$214	1598%
Multiplan/Phcs	$214 - $221	1598%

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 $233.
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 Children's Hospital 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.