CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Astria Sunnyside Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $198
Cash Discount Price: $166
vs. Medicare Baseline: 14.79x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Astria Sunnyside Hospital is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 14.79x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$198

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: $166 (1240%)

Insurance Median: $198 (1479%)

Cash: $166 (1240% of Medicare)

Ins. Median: $198 (1479% 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 1479% of the Medicare baseline (a markup of 1379%). 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
Medicare (plans)	$12 - $14	90%
Aetna	$13 - $283	97%
Healthcomp_Ihs	$13	97%
Humana	$13 - $290	97%
Va	$13	97%
Tricare	$14	105%
Medicaid / KanCare	$64 - $99	478%
Molina	$64 - $79	478%
Regence	$134 - $166	1001%
Cigna	$157 - $193	1173%
Li	$160 - $198	1195%
First_Choice	$196 - $242	1464%
Tpsc	$204 - $251	1524%
Kaiser	$205 - $253	1531%
Premera	$212 - $262	1583%
UnitedHealthcare	$222 - $274	1658%
Fhpw	$230 - $283	1718%
Healthcomp	$235 - $290	1755%
Bcchp	$261 - $322	1949%
Great_Rivers	$261 - $322	1949%
Zenith	$261 - $322	1949%

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 $166.
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 Astria Sunnyside 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.