CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Medical City Plano

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $16
  • Cash Discount Price: $1,565
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Medical City Plano is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,565. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.52x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
$1,565

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $1,565 (14820%)
Insurance Median: $16 (152%)
Cash: $1,565 (14820% of Medicare)
Ins. Median: $16 (152% 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.

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%
United $9 - $272 85%
Aetna $10 - $947 95%
Cigna $10 - $219 95%
Molina $10 - $12 95%
Parkland Community Health Plan $10 95%
American Health Plan Of Texas, Inc. $11 104%
Blue Cross Blue Shield $11 - $695 104%
Care N Care $11 104%
Devoted Health $11 104%
Humana $11 - $117 104%
Integranet $11 104%
Mutual Of Omaha $11 104%
Procare Advantge $11 104%
Provider Partners Health Plan $11 104%
Superior Health Plan $11 - $110 104%
Texas Independent Health Plan $11 104%
Triwest Health Alliance $11 104%
Triwest Veterans $11 104%
Wellcare $11 104%
Wellmed $11 104%
Imperial Insurance Company $12 114%
Universal Healthcare Group $13 123%
Verda Health Plan $14 133%
Bravo Health $16 152%
Superior $19 - $24 180%
Usa Managed Care $20 - $1,252 189%
Corvel Corporation $21 199%
Oscar $27 256%
Molina Healthcare $28 265%
Healthcare Highways $383 - $529 3627%
Evry Health $404 3826%
Lifecare Hospitals $469 4441%
Prominence Health Plan $626 5928%
City Of Mckinney $704 6667%
Fidelis Securecare $704 6667%
National Choicecare $782 7405%
Pc Texas Partners $861 8153%
Physicians Coop Of Tx $861 8153%
Rockport Health Group $861 8153%
Averde Health, Inc $908 8598%
Texas Healthcare Foundation Wc $1,017 9631%
Coastal Comp Health Networks $1,095 10369%
Mega Life $1,095 10369%
Multiplan Phcs $1,095 10369%
Healthsmart Preferred Care $1,174 11117%
Lewisville Isd/Dls Consulting $1,174 11117%
Usc Health Services $1,252 11856%
Galaxy Health Network $1,330 12595%
Independent Medical Systems $1,565 14820%
National Healthcare Solutions $1,565 14820%
Unicare $1,565 14820%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals