CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Texas Health Presbyterian Hospital Rockwall

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $405
Cash Discount Price: $359
vs. Medicare Baseline: 30.25x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Texas Health Presbyterian Hospital Rockwall is $405. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $359. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 30.25x the Medicare baseline. Located in 3150 Horizon Road, Rockwall, TX.

Cash / Self-Pay

$359

Average discount available for prompt cash payment at this facility.

Insurance Median

$405

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: $359 (2681%)

Insurance Median: $405 (3025%)

Cash: $359 (2681% of Medicare)

Ins. Median: $405 (3025% 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 3025% of the Medicare baseline (a markup of 2925%). 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
Amerigroup	$11 - $14	82%
Blue Cross Blue Shield	$11 - $78	82%
Parkland	$11	82%
UnitedHealthcare	$11 - $15	82%
Molina	$12 - $14	90%
Superior Wellcare	$12 - $15	90%
American Health	$13	97%
Healthspring	$14	105%
Humana	$14	105%
Fort Worth Firefighters	$26 - $399	194%
Aetna	$45 - $458	336%
Cigna	$67 - $614	500%
City Of Fort Worth	$273 - $307	2039%
Quick Trip	$348 - $411	2599%
Phcs	$403 - $486	3010%
Healthsmart	$435 - $549	3249%
Multiplan	$505 - $568	3771%
Galaxy	$511 - $575	3816%
Usa	$511 - $575	3816%

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 $359.
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 Health Presbyterian Hospital Rockwall 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.