CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: UT Health East Texas Rehabilitation Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $120
Cash Discount Price: $29
vs. Medicare Baseline: 11.36x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at UT Health East Texas Rehabilitation Hospital is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 11.36x the Medicare baseline. Located in 701 Olympic Plaza Cir, Tyler, TX.

Cash / Self-Pay

$29

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $29 (275%)

Insurance Median: $120 (1136%)

Cash: $29 (275% of Medicare)

Ins. Median: $120 (1136% 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 1136% of the Medicare baseline (a markup of 1036%). 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 Commercial [5055]	$72	682%
Black Lung [6055]	$72	682%
Cigna	$72 - $194	682%
Healthcare Highways [2210]	$72	682%
Healthscope Benefits [2290]	$72	682%
Lucent Health [6000]	$72	682%
Parkland Community Health Plan [6015]	$72	682%
Web Tpa [2115]	$72 - $120	682%
Blue Cross Blue Shield	$98 - $148	928%
Aetna	$120	1136%
Mailhandlers [1595]	$120	1136%
Andrews Center Behavioral Health [3950]	$145	1373%
Healthfirst [2395]	$145	1373%
Group Pension Admin [1450]	$194	1837%
Humana	$194	1837%
Phcs [1780]	$194	1837%
Tml [1980]	$194	1837%

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 $29.
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 UT Health East Texas Rehabilitation Hospital 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.