CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Tops Surgical Specialty Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $11
Cash Discount Price: $284
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Tops Surgical Specialty Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $284. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 1.30x the Medicare baseline. Located in 17080 Red Oak Drive, Houston, TX.

Cash / Self-Pay

$284

Average discount available for prompt cash payment at this facility.

Insurance Median

$11

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)

Cash / Self-Pay: $284 (3357%)

Insurance Median: $11 (130%)

Cash: $284 (3357% of Medicare)

Ins. Median: $11 (130% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.46 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.

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
Aetna	$1 - $359	12%
Ambetter / Centene	$1 - $4,848	12%
Oscar Health Plan	$1 - $9	12%
UnitedHealthcare	$7 - $10	83%
Blue Cross Blue Shield	$9 - $14	106%
Cigna	$11	130%
Health Net	$13	154%

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 $284.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80048.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Tops Surgical Specialty Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80048.
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.