CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Texas Orthopedic Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $12
  • Cash Discount Price: $1,586
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Texas Orthopedic Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,586. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.14x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$1,586

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $1,586 (15019%)
Insurance Median: $12 (114%)
Cash: $1,586 (15019% of Medicare)
Ins. Median: $12 (114% 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%
Community Health Choice Mcd $9 85%
Texas Childrens Health Plans $9 - $263 85%
Texas Health Network $9 85%
Aetna $10 - $61 95%
Molina Healthcare $10 - $23 95%
Oscar $10 - $31 95%
United $10 - $714 95%
American Health Plan $11 104%
Blue Cross Blue Shield $11 - $555 104%
Christus (Usfhp) $11 104%
Cigna $11 - $56 104%
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%
Shared Health $11 104%
Superior Health Plan $11 - $95 104%
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 $381 3608%
Evry Health $433 4100%
Imagine Health $555 5256%
Healthsmart Preferred Care $682 - $1,348 6458%
Averde Health $714 6761%
Fidelis Securecare Of Tx $714 6761%
Coventry National First Health $845 8002%
Physicians Cooperative Of Texas $872 8258%
Rockport Workers Comp $872 8258%
Independent Medical System $952 9015%
National Healthcare Solutions $952 9015%
Southwest Medical $952 9015%
Coastal Comp $1,031 9763%
Multiplan $1,190 - $1,348 11269%
International Health Insurance $1,269 12017%
Physicians, Inc $1,348 12765%
Affiliated Ppo $1,427 13513%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals