CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Portsmouth Regional Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $150
Cash Discount Price: $411
vs. Medicare Baseline: 11.20x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Portsmouth Regional Hospital is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $411. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 11.20x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.

Cash / Self-Pay

$411

Average discount available for prompt cash payment at this facility.

Insurance Median

$150

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: $411 (3069%)

Insurance Median: $150 (1120%)

Cash: $411 (3069% of Medicare)

Ins. Median: $150 (1120% 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 1120% of the Medicare baseline (a markup of 1020%). 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
Amerihealth Caritas	$12	90%
Well Sense Health Plan	$12	90%
Aetna	$13 - $348	97%
Humana	$13	97%
United Behavioral Health	$13	97%
United Va Ccn	$13	97%
Blue Cross Blue Shield	$14 - $243	105%
Cigna	$14 - $70	105%
Evernorth Behavioral Health	$14	105%
Martin'S Point Health	$14	105%
Sierra Military Health	$14	105%
United	$14 - $362	105%
Ambetter / Centene	$24	179%
Harvard Pilgrim	$57 - $236	426%
Maine Community Health	$85 - $291	635%
Tufts Health Plan	$102 - $314	762%
Mvp Health Plan	$190 - $384	1419%
Corvel	$196 - $395	1464%
Evernorth	$218 - $439	1628%
Mutual Of Omaha	$218 - $439	1628%
Multiplan	$220 - $445	1643%
First Health	$248 - $500	1852%
Healthcare Value Mgmt	$248 - $500	1852%
Oxford Health Plans	$258 - $522	1927%

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 $411.
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 Portsmouth Regional 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.