CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Raritan Bay Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $66
  • Cash Discount Price: $13
  • vs. Medicare Baseline: 4.93x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Raritan Bay Medical Center is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 4.93x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.
Cash / Self-Pay
$13

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $13 (97%)
Insurance Median: $66 (493%)
Cash: $13 (97% of Medicare)
Ins. Median: $66 (493% 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 493% of the Medicare baseline (a markup of 393%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $4 - $204 30%
Vaccn $13 97%
Wellcare $13 97%
Amerigroup $13 - $14 97%
Seoul Medical Group $13 97%
Clover $13 97%
United Community/Americhoice $14 105%
UnitedHealthcare $16 - $29 119%
Karna $18 134%
Qualcare $22 - $236 164%
Bergen Risk $25 - $195 187%
Horizon $25 - $251 187%
Activecare First McO $25 - $195 187%
Brighton Health Plan $26 - $208 194%
Cigna $26 - $208 194%
Oxford $27 202%
Multiplan - PHCS $28 - $221 209%
Amerihealth $29 - $253 217%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 New Brunswick Ave, Perth Amboy, NJ 08861
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals