CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Penn Presbyterian Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $184
  • Cash Discount Price: $527
  • vs. Medicare Baseline: 13.74x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Penn Presbyterian Medical Center is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $527. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 13.74x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$527

Average discount available for prompt cash payment at this facility.

Insurance Median
$184

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: $527 (3936%)
Insurance Median: $184 (1374%)
Cash: $527 (3936% of Medicare)
Ins. Median: $184 (1374% 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 1374% of the Medicare baseline (a markup of 1274%). 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
Cigna $8 - $167 60%
Blue Cross Blue Shield $13 - $527 97%
Medicare (plans) $13 - $14 97%
Philadelphia Va Medical Center $13 97%
Upmc $13 - $527 97%
Aetna $14 - $527 105%
Clover Health Plan $14 105%
Geisinger Health Plan $14 - $42 105%
Health Partners $14 - $527 105%
Humana $14 - $422 105%
Ibc $14 105%
Medicaid / KanCare $14 - $527 105%
Pa Health And Wellness $14 - $22 105%
Pa Medical Assistance $14 105%
Penn Life (Living Independently For Elders) $14 105%
UnitedHealthcare $14 - $527 105%
Keystone First $15 112%
Tricare $15 112%
Us Family Health Plan $15 112%
Gateway Health Plan $17 127%
Keystone Mercy Health Plan $18 - $527 134%
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%
Horizon Nj Health $89 - $93 665%
Pgm - Regie De L'Assurance Maladie Quebec $121 904%
Preferred Health Care Eliance $132 986%
Pgm - Kuwait Defense $184 - $237 1374%
Devon $200 - $237 1494%
Qualcare $200 1494%
Coventry $211 - $269 1576%
Pgm - Chop $211 1576%
Wissahickon Hospice $211 1576%
Healthamerica/Coventry $237 - $258 1770%
Olympus $250 1867%
First Health Global $264 1972%
Urn-Cancer Resource Services $264 1972%
Health Net $316 2360%
Pgm - Royal Embassy Of Saudi Arabia $316 2360%
Pgm - Embassy Of Qatar $343 2562%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $343 2562%
Pgm - Embassy Of The United Emirates/Ipc $369 2756%
Devon Health Services Inc $422 3152%
Health America/Ccn $422 3152%
Intergroup $422 3152%
Pgm - Kuwait Health Division $422 3152%
Pgm - Kuwait Oil $422 3152%
Preferred Care $422 3152%
Commercial Other $527 3936%
International Pfs $527 3936%
Magellan $527 3936%
Quest Behavioral Health $527 3936%
United Behavioral Health $527 3936%
Workers Compensation $527 3936%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals