CMS Price Transparency Data
Blood test, cholesterol (lipid panel)
Facility: St Catherine of Siena Hospital
Billing Code: 80061 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80061
- Insurance Median: $13
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at St Catherine of Siena Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 0.97x the Medicare baseline. Located in 50 Route 25A, Smithtown, NY.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$13
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%)
Insurance Median: $13 (97%)
Ins. Median: $13 (97% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Affinity Health Plan | $6 - $14 | 45% |
| Beacon Health Options | $6 - $19 | 45% |
| Beacon Health Strategies | $6 - $19 | 45% |
| Centerlight Healthcare | $6 - $13 | 45% |
| Elderplan Inc. | $6 - $13 | 45% |
| Emblem Health | $6 - $30 | 45% |
| Fidelis Care New York | $6 - $14 | 45% |
| Health First | $6 - $30 | 45% |
| Health Plus | $6 - $14 | 45% |
| Independent Health | $6 - $13 | 45% |
| Medicaid / KanCare | $6 | 45% |
| Mvp Health Plans | $6 - $33 | 45% |
| Senior Whole Health | $6 - $13 | 45% |
| UnitedHealthcare | $6 - $49 | 45% |
| Aetna | $13 - $19 | 97% |
| Blue Cross Blue Shield | $13 - $49 | 97% |
| Centers Plan For Healthy Living | $13 | 97% |
| Healthspring | $13 | 97% |
| Liberty Health | $13 | 97% |
| Longevity Health Plan | $13 | 97% |
| Medicare (plans) | $13 - $14 | 97% |
| Orthonet - Uniformed Services Family Health Plan | $13 | 97% |
| Pmc | $13 | 97% |
| Surest | $13 | 97% |
| Tricare | $13 | 97% |
| Universal Healthcare | $13 | 97% |
| Us Family Health Plan | $13 | 97% |
| Veterans Affairs | $13 | 97% |
| Agewell New York | $14 | 105% |
| Humana | $14 | 105% |
| Partners Health Plan | $14 | 105% |
| Wellcare Health Plan Inc | $15 | 112% |
| Zadroga | $18 | 134% |
| Mail Handlers Benefit Plan | $19 | 142% |
| Meritain Health | $19 | 142% |
| Nippon Life Insurance Company Of America | $19 | 142% |
| Salvation Army | $19 | 142% |
| Centivo | $20 - $33 | 149% |
| American Plan Administrators | $30 | 224% |
| Amerihealth Administrators | $30 | 224% |
| Benefit Services | $30 | 224% |
| Ghi Cbp Ny City Employee Alternate | $30 | 224% |
| International Benefit Administrator | $30 | 224% |
| Ultra Benefits Inc. | $30 | 224% |
| Apwu | $33 | 246% |
| Cigna | $33 - $177 | 246% |
| Daniel H Cook | $33 | 246% |
| Nalc | $33 | 246% |
| Samba | $33 | 246% |
| Brighton | $34 - $190 | 254% |
| Self Pay | $49 | 366% |
| Local 1199 | $76 | 568% |
| Oscar Health | $112 | 836% |
| Allied Wellfare Fund | $177 | 1322% |
| American Group Administrators | $177 | 1322% |
| Bakery & Confectionery Union | $177 | 1322% |
| Comprehensive Benefits Consultant | $177 | 1322% |
| Guardian Life Insurance Company Of America | $177 | 1322% |
| Maloney And Assoc | $177 | 1322% |
| Multiplan | $177 | 1322% |
| Performax | $177 | 1322% |
| Phcs | $177 | 1322% |
| Pomco | $177 | 1322% |
| Tpa Inc | $177 | 1322% |
| Unicare | $177 | 1322% |
| United Employees Health Plan | $177 | 1322% |
| Coventry | $201 - $218 | 1501% |
| Magellan | $218 | 1628% |
| Galaxy | $245 | 1830% |
| Three Rivers Provider Network | $245 | 1830% |
| Aither Health | $272 | 2031% |
| Alpha Care | $272 | 2031% |
| Dentaquest | $272 | 2031% |