CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: St Christopher's Hospital for Children

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $125
  • Cash Discount Price: $313
  • vs. Medicare Baseline: 9.34x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at St Christopher's Hospital for Children is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $313. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 9.34x the Medicare baseline. Located in 160 East Erie Ave, Philadelphia, PA.
Cash / Self-Pay
$313

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $313 (2338%)
Insurance Median: $125 (934%)
Cash: $313 (2338% of Medicare)
Ins. Median: $125 (934% 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 934% of the Medicare baseline (a markup of 834%). 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
Amerihealth Caritas $14 105%
UnitedHealthcare $16 - $21 119%
Geisinger $17 - $282 127%
Pa Health & Wellness $19 142%
Cigna $21 157%
Aetna $24 - $470 179%
Upmc $25 187%
Gateway $31 232%
Horizon Nj Health $31 232%
Blue Cross Blue Shield $49 - $339 366%
Health Partners $140 1046%
Wellpoint Nj (Formerly Amerigroup) $166 1240%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 160 East Erie Ave, Philadelphia, PA 19134
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Childrens