CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Texas Health Presbyterian Hospital Denton

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $395
Cash Discount Price: $400
vs. Medicare Baseline: 37.41x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Texas Health Presbyterian Hospital Denton is $395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $400. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 37.41x the Medicare baseline. Located in 3000 N I-35, Denton, TX.

Cash / Self-Pay

$400

Average discount available for prompt cash payment at this facility.

Insurance Median

$395

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: $400 (3788%)

Insurance Median: $395 (3741%)

Cash: $400 (3788% of Medicare)

Ins. Median: $395 (3741% 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 3741% of the Medicare baseline (a markup of 3641%). 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
Amerigroup	$9 - $11	85%
Blue Cross Blue Shield	$9 - $62	85%
Cook Childrens	$9	85%
Superior Wellcare	$9 - $12	85%
UnitedHealthcare	$9 - $12	85%
Aetna	$10 - $476	95%
Molina	$10 - $11	95%
American Health	$11	104%
Healthspring	$11	104%
Humana	$11	104%
Fort Worth Firefighters	$21 - $415	199%
Cigna	$43 - $639	407%
City Of Fort Worth	$307 - $319	2907%
Quick Trip	$392 - $428	3712%
Phcs	$454 - $506	4299%
Healthsmart	$490 - $571	4640%
Multiplan	$568 - $591	5379%
Galaxy	$575 - $598	5445%
Usa	$575 - $598	5445%

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 $400.
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 Texas Health Presbyterian Hospital Denton 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.