CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $128
Cash Discount Price: $178
vs. Medicare Baseline: 9.56x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Texas Childrens Hospital North Austin Campus is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 9.56x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$178

Average discount available for prompt cash payment at this facility.

Insurance Median

$128

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: $178 (1329%)

Insurance Median: $128 (956%)

Cash: $178 (1329% of Medicare)

Ins. Median: $128 (956% 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 956% of the Medicare baseline (a markup of 856%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Superior Chip	$13 - $14	97%
Driscoll Children'S Health Plan Mcd	$15	112%
Community Health Choice	$23 - $246	172%
First Care Health Plan	$39 - $246	291%
UnitedHealthcare	$39 - $246	291%
Molina Mcd	$44 - $116	329%
Blue Cross Blue Shield	$51 - $243	381%
Community First Health Plan Mcd	$58 - $154	433%
Cook Children'S Health Plan	$58 - $154	433%
Cigna	$83 - $246	620%
Aetna	$93 - $246	695%
Kelseycare	$95 - $250	709%
Healthsmart	$102 - $270	762%
Evolutions Healthcare	$110 - $289	822%
First Health	$128 - $366	956%
Multiplan	$131 - $346	978%
Galaxy Health Network	$139 - $366	1038%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $178.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80061.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Texas Childrens Hospital North Austin Campus is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80061.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.