CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Adventist Health Portland

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $36
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 2.69x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Adventist Health Portland is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 2.69x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $27 (202%)
Insurance Median: $36 (269%)
Cash: $27 (202% of Medicare)
Ins. Median: $36 (269% 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 269% of the Medicare baseline (a markup of 169%). 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 $11 - $12 82%
Care Oregon - All Plans $11 82%
Healthnet Epo/Pos/Ppo $11 - $12 82%
Healthnet Hmo/Pos - All Other Plans $11 - $12 82%
Ods - All Plans $11 82%
Pacific Source Comm - All Plans $11 - $12 82%
Providence Hp - All Plans $11 - $12 82%
Kaiser Mcr Adv $13 97%
Humana $14 105%
Moda Mcr Adv $14 105%
UnitedHealthcare $14 - $132 105%
Healthnet Mcr Adv $15 112%
Healthcare Resources - All Plans $18 - $20 134%
Ah Employee Health Plan - All Plans $24 179%
Moda Conn Oebb/Syn Pebb $27 202%
Workers Comp $28 - $30 209%
Moda Affinity - All Other Plans $31 232%
Cigna $32 239%
Regence Ohsu Plus $33 246%
Kaiser - All Other Plans $35 261%
Regence - All Other Plans $37 276%
Bc Premera First - All Plans $40 - $44 299%
Moda Select $42 314%
Moda Connexus $47 351%
Worldventure - All Plans $48 - $53 358%
Moda Synergy $50 373%
Regence Preferred Mcr Adv $52 - $57 388%
First Choice - All Plans $55 - $61 411%
Multiplan - All Plans $60 - $66 448%
Phcs - All Plans $60 - $66 448%
Regence Mcr Adv $61 - $67 456%
First Health-Coventry - All Plans $64 - $70 478%
National Provider Network - All Plans $70 - $77 523%
Health Payors Organization Ltd- All Plans $72 - $79 538%
Moda Ohsu Ppo/Epo/Hmc $144 - $158 1075%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals