CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Rio Grande Regional Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $18
  • Cash Discount Price: $2,045
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Rio Grande Regional Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,045. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 1.34x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$2,045

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $2,045 (15273%)
Insurance Median: $18 (134%)
Cash: $2,045 (15273% of Medicare)
Ins. Median: $18 (134% 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
Aetna $8 - $14 60%
Driscoll Children'S Health Plan $8 60%
Molina Healthcare $8 - $33 60%
Texas Health Network $8 60%
United $8 - $920 60%
Allegian Health $13 - $818 97%
Blue Cross Blue Shield $13 - $920 97%
Cigna $13 - $49 97%
Humana $13 - $47 97%
Independent Medical System $13 97%
Triwest Healthcare Alliance $13 97%
Wellmed $13 97%
American Health Plan $14 105%
Physicians Health Choice $14 105%
Prominence Health $14 105%
Provider Partners Health Plan Of Texas $14 105%
Shared Health $14 105%
Superior Health Plan $14 - $143 105%
Triwest Health Alliance $14 105%
Molina $15 112%
Universal Health Care $16 119%
Superior $21 157%
Corvel Corporation $27 202%
Focus Healthcare $27 202%
Omni Healthcare $28 209%
Oscar $31 232%
Healthcare Highways $40 299%
Texas Workforce Commission $491 3667%
Averde Health $675 5041%
Healthsmart Preferred Care $879 - $1,738 6565%
First Health $1,176 8783%
National Healthcare Solutions $1,227 9164%
Southwest Medical $1,227 9164%
Coastal Comp $1,329 9925%
Usa Managed Care $1,329 - $1,636 9925%
Ppo Next/ Medical Control $1,534 11456%
Beech Street $1,636 12218%
Multiplan $1,636 12218%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 E Ridge Rd, McAllen, TX 78503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals