CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $106
  • Cash Discount Price: $480
  • vs. Medicare Baseline: 7.92x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Hospital of Univ of Pennsylvania is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $480. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 7.92x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$480

Average discount available for prompt cash payment at this facility.

Insurance Median
$106

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: $480 (3585%)
Insurance Median: $106 (792%)
Cash: $480 (3585% of Medicare)
Ins. Median: $106 (792% 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 792% of the Medicare baseline (a markup of 692%). 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
Gspp And Wissahickon Hospice $7 52%
Cigna $8 - $216 60%
UnitedHealthcare $12 - $480 90%
Blue Cross Blue Shield $13 - $326 97%
Kaiser Permanente $13 - $480 97%
Medicare (plans) $13 - $14 97%
Philadelphia Va Medical Center $13 97%
Upmc $13 - $480 97%
Aetna $14 - $480 105%
Clover Health Plan $14 105%
Devoted Health $14 105%
Geisinger Health Plan $14 - $42 105%
Health Partners $14 - $480 105%
Humana $14 - $384 105%
Ibc $14 105%
Medicaid / KanCare $14 - $480 105%
Pa Health And Wellness $14 - $22 105%
Pa Medical Assistance $14 - $480 105%
Penn Life (Living Independently For Elders) $14 105%
Keystone First $15 112%
Tricare $15 112%
Us Family Health Plan $15 112%
Gateway Health Plan $17 127%
Keystone Mercy Health Plan $18 - $480 134%
Elap $19 142%
Claims Watcher $21 - $24 157%
Ibc Commercial Hpn $22 164%
Keystone Hmo Proactive $22 164%
Oscar Health Plan $23 172%
Centivo $24 179%
Elap Services $25 187%
Highmark $28 209%
Penn Global Medicine $35 261%
Paired Kidney Exchange $38 284%
Horizon Nj Health $81 - $84 605%
Preferred Health Care Eliance $106 792%
Pgm - Regie De L'Assurance Maladie Quebec $110 822%
Pgm - Kuwait Defense $168 - $216 1255%
Qualcare $182 1359%
Olympus $189 1412%
Coventry $192 - $245 1434%
Pgm - Chop $192 1434%
Wissahickon Hospice $192 1434%
Healthamerica/Coventry $216 - $235 1613%
First Health Global $240 1792%
Health Net $288 2151%
Pgm - Royal Embassy Of Saudi Arabia $288 2151%
Pgm - Embassy Of Qatar $312 2330%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $312 2330%
Interlink $322 2405%
Pgm - Embassy Of The United Emirates/Ipc $336 2509%
Health America/Ccn $384 2868%
Intergroup $384 2868%
Pgm - Kuwait Health Division $384 2868%
Pgm - Kuwait Oil $384 2868%
Preferred Care $384 2868%
Blue Quality Centers For Transplant (Bqct) $480 3585%
City Of Philadelphia Behavioral Health $480 3585%
Commercial Other $480 3585%
International Pfs $480 3585%
United Behavioral Health $480 3585%
Workers Compensation $480 3585%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals