CMS Price Transparency Data
Blood test, cholesterol (lipid panel)
Facility: Watsonville Community Hospital
Billing Code: 80061 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80061
- Insurance Median: $680
- Cash Discount Price: $739
- vs. Medicare Baseline: 50.78x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Watsonville Community Hospital is $680. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $739. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 50.78x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$739
Average discount available for prompt cash payment at this facility.
Insurance Median
$680
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: $739 (5519%)
Insurance Median: $680 (5078%)
Cash: $739 (5519% of Medicare)
Ins. Median: $680 (5078% 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 5078% of the Medicare baseline (a markup of 4978%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Travelers Insurance | $13 - $1,232 | 97% |
| Tricare | $13 | 97% |
| Keenan & Assoc Work Comp | $13 | 97% |
| Pinnacle Healthcare Uc | $13 | 97% |
| Medicare (plans) | $13 | 97% |
| Fleming & Associates | $13 | 97% |
| Alignment Health Plan | $13 | 97% |
| Blue Shield PPO | $13 - $43 | 97% |
| Miscellaneous Work Comp | $13 | 97% |
| Ace-Usa | $13 | 97% |
| Hartford Workers' Comp | $13 | 97% |
| Fireman's Fund Work Comp | $13 | 97% |
| UnitedHealthcare | $13 - $739 | 97% |
| U.S. Dept. of Labor | $13 | 97% |
| Nx Health Network | $13 | 97% |
| Republic Idemnity W/Comp | $13 | 97% |
| Workers Comp | $13 | 97% |
| Health Net of California | $13 - $772 | 97% |
| Kemper Group Workers Comp | $13 | 97% |
| Beta Healthcare Group | $13 | 97% |
| Secure Horizons | $13 | 97% |
| Western Growers Work Comp | $13 | 97% |
| Secure Horizons Dign HMO | $13 - $246 | 97% |
| Veterans Administration | $13 | 97% |
| Liberty Mutual Work Comp | $13 | 97% |
| Crawford & Co | $13 | 97% |
| Gallagher Bassett Svcs | $13 | 97% |
| Medi-Cal E.R. | $17 | 127% |
| Healthy Families | $17 - $43 | 127% |
| Medi-Cal/Eds | $17 | 127% |
| Well Path | $17 - $1,232 | 127% |
| Ccs/Monterey County | $17 | 127% |
| Medicaid / KanCare | $17 | 127% |
| California Childrens Srvs | $17 | 127% |
| Alliance/Sccho | $18 | 134% |
| Ufcw/Valley Clerks | $43 | 321% |
| Bs Employee | $43 | 321% |
| United Agriculture | $43 | 321% |
| Pacificare HMO | $74 - $739 | 553% |
| Health Net Pmg HMO | $74 - $772 | 553% |
| Cigna | $74 - $862 | 553% |
| Great-West/Phcs | $74 - $862 | 553% |
| Blue Shield HMO | $74 - $246 | 553% |
| Blue Cross Blue Shield | $74 - $1,097 | 553% |
| Aetna | $74 - $1,010 | 553% |
| Carpenters H&W Trust | $89 - $1,097 | 665% |
| Robert Kennedy/Ccn | $89 - $1,097 | 665% |
| Western Growers Trust/Bc | $89 - $1,097 | 665% |
| Monterey Bay Pub Emp Trst | $89 - $1,097 | 665% |
| Sheet Metal Workers | $89 - $1,097 | 665% |
| State Compensation Fund | $89 - $1,097 | 665% |
| City of Wats/Pinnacle Clm | $89 - $1,097 | 665% |
| Claims Management Wc | $89 - $1,097 | 665% |
| Teamsters Benefit Trust | $89 - $1,097 | 665% |
| Calif Ironworkers Field | $89 - $1,097 | 665% |
| Operating Engineers | $89 - $1,097 | 665% |
| Pinnacle Claims Tpa/Bc | $89 - $1,097 | 665% |
| Delta Health Systems | $89 - $1,097 | 665% |
| Laborers Health & Welfare | $89 - $1,097 | 665% |
| Medicruz | $222 | 1658% |
| Victim Compensation Plan | $222 - $1,232 | 1658% |
| Western Health Advantage | $616 | 4600% |
| Health Net Smartcare Netw | $739 | 5519% |
| Self Pay | $739 | 5519% |
| Pacificare PPO | $739 | 5519% |
| Health Net Blue and Gold | $772 | 5765% |
| Health Net Canopycare HMO | $772 | 5765% |
| First Health | $862 - $985 | 6438% |
| Geha (Ccn) | $862 - $985 | 6438% |
| Adventist Risk Management | $862 - $985 | 6438% |
| Transwestern | $862 - $985 | 6438% |
| Multiplan Inc PPO | $961 | 7177% |
| Private Healthcare System | $961 | 7177% |
| Coastal Healthcare Admin | $1,047 - $1,109 | 7819% |
| Salinas Valley Mem Hops | $1,047 | 7819% |
| Physicians Mutual | $1,232 | 9201% |
| Zenith National Ins | $1,232 | 9201% |
| State Farm Ins | $1,232 | 9201% |
| Miscellaneous Insurance | $1,232 | 9201% |
| Allstate | $1,232 | 9201% |
| United Administrative | $1,232 | 9201% |
| Prucare Pmg HMO | $1,232 | 9201% |
| Aarp | $1,232 | 9201% |
| Farmers Insurance | $1,232 | 9201% |
| Apwu Health Plan | $1,232 | 9201% |
| Wholesale Beer Distributo | $1,232 | 9201% |
| North Calif Bakery Driver | $1,232 | 9201% |
| Bankers Life & Casualty | $1,232 | 9201% |
| Prucare Pmg POS | $1,232 | 9201% |
| Miscellaneous Auto | $1,232 | 9201% |
| Aaa | $1,232 | 9201% |
| Sutter Health Plus | $1,232 | 9201% |
| Humana | $1,232 | 9201% |