CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Reston Hospital Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $51
Cash Discount Price: $1,074
vs. Medicare Baseline: 3.81x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Reston Hospital Center is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,074. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.81x the Medicare baseline. Located in 1850 Town Center Parkway, Reston, VA.

Cash / Self-Pay

$1,074

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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: $1,074 (8021%)

Insurance Median: $51 (381%)

Cash: $1,074 (8021% of Medicare)

Ins. Median: $51 (381% 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 381% of the Medicare baseline (a markup of 281%). 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
United	$13 - $483	97%
Humana	$13 - $14	97%
Johns Hopkins	$13	97%
Sentara Health	$13	97%
Devoted	$13	97%
Pyramid Life	$14	105%
Clear Spring Health Plan	$14	105%
Align Senior Care	$14	105%
Davita Village Health	$14	105%
Aetna	$14	105%
Blue Cross Blue Shield	$14 - $70	105%
Cigna	$14 - $53	105%
Virginia Premier Health	$14	105%
Bright Health	$29	217%
Carefirst	$76	568%
Lifeworks	$204	1524%
Universal Healthcare Group	$236	1763%
Greenvbrier Sporting Club	$644	4810%
Virginia Health Network	$763	5698%
Corvel	$773	5773%
Occunet Workers Comp	$859	6415%
4Most Health Network	$967	7222%

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 $1,074.
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 Reston Hospital Center 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.