CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: OHSU Hospital and Clinics

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $31
Cash Discount Price: $59
vs. Medicare Baseline: 2.32x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at OHSU Hospital and Clinics is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.32x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

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: $59 (441%)

Insurance Median: $31 (232%)

Cash: $59 (441% of Medicare)

Ins. Median: $31 (232% 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 232% of the Medicare baseline (a markup of 132%). 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
Care Oregon	$11 - $16	82%
Intercommunity Health Network	$11	82%
Kaiser Foundation Hospitals	$11 - $31	82%
Medicare (plans)	$11 - $21	82%
Pacific Source	$11 - $79	82%
Humana	$13 - $14	97%
Trillium	$13	97%
Aetna	$14 - $58	105%
Moda	$14 - $80	105%
Samaritan Health Plan	$14 - $33	105%
UnitedHealthcare	$14 - $24	105%
Health Net Health Plan Of Oregon, Inc.	$15 - $101	112%
Community Health Plan Of Washington	$16 - $25	119%
Providence Health Plan	$16 - $40	119%
Cigna	$39	291%
Blue Cross Blue Shield	$46	344%
Tuality Health	$53 - $84	396%
Coventry First Health	$61 - $98	456%
First Choice	$61 - $98	456%
Molina Exchange	$81 - $130	605%

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 $59.
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 OHSU Hospital and Clinics 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.