CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Hospital Metropolitano Dr Pila

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $25
  • Cash Discount Price: $96
  • vs. Medicare Baseline: 1.87x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Hospital Metropolitano Dr Pila is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.87x the Medicare baseline. Located in 2435 Boulevard Luis A Ferre, Ponce, PR.
Cash / Self-Pay
$96

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

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: $96 (717%)
Insurance Median: $25 (187%)
Cash: $96 (717% of Medicare)
Ins. Median: $25 (187% 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.

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
First Medical $13 - $30 97%
Mso $13 - $16 97%
Privado $13 97%
Triple S $15 - $25 112%
Humana $18 - $29 134%
Ch $19 142%
Hospicio $19 142%
Mcs $19 - $25 142%
Medicare (plans) $19 142%
Salud Correccional $19 142%
Tricare $19 142%
Va $19 142%
Prossam $21 157%
Acaa $25 187%
Mapfre $25 187%
Auxilio Mutuo $28 209%
Bl $28 209%
Plan De Salud Menonita $29 - $40 217%
Aarp $30 224%
Fondo Del Seguro Estado $34 254%
Cigna $39 291%
Comerciales $45 336%
Life Link $45 336%
Wellcare $45 336%
Mc $60 448%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2435 Boulevard Luis A Ferre, Ponce, PR 00717
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals