CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Baylor Scott & White Medical Center Hillcrest

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $72
Cash Discount Price: $149
vs. Medicare Baseline: 6.82x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Baylor Scott & White Medical Center Hillcrest is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 6.82x the Medicare baseline. Located in 100 Hillcrest Medical Blvd, Waco, TX.

Cash / Self-Pay

$149

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$10.56

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $10.56 (100%)

Cash / Self-Pay: $149 (1411%)

Insurance Median: $72 (682%)

Cash: $149 (1411% of Medicare)

Ins. Median: $72 (682% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $10.56 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 682% of the Medicare baseline (a markup of 582%). 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
Baylor Scott & White Health Plan	$10 - $106	95%
American Health Plan	$11	104%
Blue Cross Blue Shield	$11 - $63	104%
Corvel	$11	104%
Humana	$11 - $173	104%
Prime Health Services	$11	104%
Procare Advantage	$11	104%
Triwest	$11	104%
UnitedHealthcare	$12 - $15	114%
Injury Management Organization	$13	123%
Sedgwick	$16	152%
Superior Health Plan	$30	284%
Texas Workforce Commission	$82	777%
Cigna	$127 - $149	1203%
Aetna	$136	1288%
Midcoast	$136	1288%
Quiktrip	$136	1288%
University Of Mary Hardin-Baylor	$144	1364%
Independent Medical System	$149	1411%
Imagine Health	$155	1468%
Curative	$161	1525%
First Health	$173	1638%
Healthsmart	$173 - $186	1638%
Private Health Care System	$186	1761%

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 $149.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80053.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Baylor Scott & White Medical Center Hillcrest is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80053.
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.