CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Prosser Memorial Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $157
Cash Discount Price: $108
vs. Medicare Baseline: 11.73x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Prosser Memorial Hospital is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 11.73x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$108

Average discount available for prompt cash payment at this facility.

Insurance Median

$157

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: $108 (807%)

Insurance Median: $157 (1173%)

Cash: $108 (807% of Medicare)

Ins. Median: $157 (1173% 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 1173% of the Medicare baseline (a markup of 1073%). 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
UnitedHealthcare	$23 - $79	172%
Kaiser Permanente	$39 - $178	291%
Community Health Plan Of Washington	$42 - $79	314%
Coordinated Care	$42 - $79	314%
Amerigroup	$44 - $84	329%
Molina	$44 - $79	329%
Health Alliance Northwest	$49	366%
Humana	$49 - $167	366%
Wellcare	$49	366%
Aetna	$59 - $167	441%
Ambetter / Centene	$137 - $151	1023%
Asuris	$157 - $176	1173%
Health Management Adminstrators	$157 - $176	1173%
Premera	$157	1173%
Regence	$157 - $176	1173%
Cigna	$161	1202%
First Choice	$167	1247%
Multiplan	$167 - $176	1247%

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 $108.
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 Prosser Memorial Hospital 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.