CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Rio Grande Regional Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $15
  • Cash Discount Price: $2,823
  • vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Rio Grande Regional Hospital is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,823. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.42x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$2,823

Average discount available for prompt cash payment at this facility.

Insurance Median
$15

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: $2,823 (26733%)
Insurance Median: $15 (142%)
Cash: $2,823 (26733% of Medicare)
Ins. Median: $15 (142% 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
Texas Health Network $9 85%
Aetna $10 - $11 95%
Driscoll Children'S Health Plan $10 95%
Molina Healthcare $10 - $26 95%
United $10 - $1,270 95%
Wellmed $10 95%
Allegian Health $11 - $1,129 104%
American Health Plan $11 104%
Blue Cross Blue Shield $11 - $1,270 104%
Cigna $11 - $39 104%
Humana $11 - $37 104%
Independent Medical System $11 104%
Physicians Health Choice $11 104%
Prominence Health $11 104%
Provider Partners Health Plan Of Texas $11 104%
Shared Health $11 104%
Superior Health Plan $11 - $198 104%
Triwest Health Alliance $11 104%
Triwest Healthcare Alliance $11 104%
Molina $12 114%
Universal Health Care $13 123%
Superior $16 152%
Corvel Corporation $21 199%
Focus Healthcare $21 199%
Omni Healthcare $22 208%
Oscar $25 237%
Healthcare Highways $32 303%
Texas Workforce Commission $678 6420%
Averde Health $932 8826%
Healthsmart Preferred Care $1,214 - $2,400 11496%
First Health $1,623 15369%
National Healthcare Solutions $1,694 16042%
Southwest Medical $1,694 16042%
Coastal Comp $1,835 17377%
Usa Managed Care $1,835 - $2,259 17377%
Ppo Next/ Medical Control $2,117 20047%
Beech Street $2,259 21392%
Multiplan $2,259 21392%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 E Ridge Rd, McAllen, TX 78503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals