CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: HCA Houston Healthcare West

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $34
  • Cash Discount Price: $1,959
  • vs. Medicare Baseline: 3.22x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at HCA Houston Healthcare West is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,959. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 3.22x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
$1,959

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $1,959 (18551%)
Insurance Median: $34 (322%)
Cash: $1,959 (18551% of Medicare)
Ins. Median: $34 (322% 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 322% of the Medicare baseline (a markup of 222%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Amerigroup $9 - $11 85%
Community Health Choice Mcd $9 85%
Texas Childrens Health Plans $9 - $348 85%
Texas Health Network $9 85%
Aetna $10 - $69 95%
Molina Healthcare $10 - $23 95%
Oscar $10 - $31 95%
United $10 - $944 95%
American Health Plan $11 104%
Blue Cross Blue Shield $11 - $734 104%
Chc Harris Health $11 104%
Christus (Usfhp) $11 104%
Cigna $11 - $1,678 104%
Devoted Health $11 104%
Humana $11 - $141 104%
Integranet Amerigroup Ipa $11 104%
Kelsey Seybold $11 104%
Procare Advantage $11 104%
Provider Partners Health Plan Of Texas $11 104%
Renaissance Ipa Radiology $11 104%
Shared Health $11 104%
Superior Health Plan $11 - $126 104%
Triwest Health Alliance $11 104%
Triwest Healthcare Alliance $11 104%
Van Lang Ipa $11 104%
Wellcare $11 104%
Wellmed $11 104%
Molina $12 114%
Universal Healthcare Group $13 123%
Verda Health Plan $14 133%
Community Health Choice $15 142%
Superior $15 - $16 142%
Corvel Corporation $21 199%
Omni Healthcare $22 208%
Healthcare Highways $32 303%
Texas Workforce Commission $437 - $503 4138%
Evry Health $497 - $572 4706%
Imagine Health $637 - $734 6032%
Healthsmart Preferred Care $783 - $1,782 7415%
Averde Health $819 - $944 7756%
Fidelis Securecare Of Tx $819 - $944 7756%
Coventry National First Health $971 - $1,118 9195%
Physicians Cooperative Of Texas $1,002 - $1,153 9489%
Rockport Workers Comp $1,002 - $1,153 9489%
Independent Medical System $1,093 - $1,258 10350%
National Healthcare Solutions $1,093 - $1,258 10350%
Southwest Medical $1,093 - $1,258 10350%
Triumph $1,093 - $1,258 10350%
Coastal Comp $1,184 - $1,363 11212%
Multiplan $1,366 - $1,782 12936%
Physicians, Inc $1,548 - $1,782 14659%
Affiliated Ppo $1,639 - $1,887 15521%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals