CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: North Austin Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $73
  • Cash Discount Price: $1,462
  • vs. Medicare Baseline: 6.91x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at North Austin Medical Center is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,462. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 6.91x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$1,462

Average discount available for prompt cash payment at this facility.

Insurance Median
$73

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: $1,462 (13845%)
Insurance Median: $73 (691%)
Cash: $1,462 (13845% of Medicare)
Ins. Median: $73 (691% 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 691% of the Medicare baseline (a markup of 591%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Superior Health Plan $8 - $344 76%
St David’S Hospice $9 - $11 85%
Blue Cross Blue Shield $10 - $596 95%
Molina Healthcare $10 - $12 95%
United $10 - $909 95%
Wellmed $10 95%
Aetna $11 - $12 104%
American Health Plan Of Texas $11 104%
Cigna $11 - $30 104%
Devoted Health $11 104%
Humana $11 - $12 104%
Odyssey Hospice $11 104%
Provider Partners Health Plan $11 104%
Pyramid Life $11 104%
Shared Health $11 104%
Texas Independent Health Plan $11 104%
Triwest Health Alliance $11 104%
Triwest Healthcare Alliance $11 104%
UnitedHealthcare $11 - $909 104%
Wellcare $11 104%
Imperial Insurance $12 114%
Sendero $12 - $18 114%
Austin Fc $13 123%
Universal Health $13 123%
Amerigroup $14 133%
Naphcare $16 152%
Seven Corners $16 152%
Corvel Corporation $21 199%
Oscar $29 - $32 275%
Moda $37 - $475 350%
Covenant Management Systems $46 - $582 436%
Healthcare Highways $46 - $606 436%
Imo Med - Select Network $48 - $606 455%
Nomi Health $51 - $748 483%
Moda Health $57 - $748 540%
Evry Health $59 - $744 559%
Texas Healthcare Foundation Heb $59 - $748 559%
Texas Workforce Commission $62 - $788 587%
Harbor Health Team $64 - $808 606%
Averde Health $72 - $909 682%
Comanche County $80 - $1,010 758%
National Choicecare $80 - $1,010 758%
Healthsmart Preferred Care $87 - $1,617 824%
Independent Medical Systems $87 - $1,112 824%
Physicians Cooperative Of Texas $87 - $1,112 824%
Prime Health $95 - $1,213 900%
First Health $99 - $1,435 938%
Coastal Comp Health Networks $103 - $1,314 975%
National Health Care $103 - $1,314 975%
Texas Municipal League $111 - $1,415 1051%
Medcorp Southwest $119 - $1,516 1127%
Rockport Healthcare Group $127 - $1,819 1203%
Bce Emergis Corporation $143 - $1,819 1354%
Beech Street $143 - $1,819 1354%
Medical Control Network Solutions $143 - $1,819 1354%
Multiplan $143 - $1,819 1354%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals