CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Dell Children's Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $26
Cash Discount Price: $166
vs. Medicare Baseline: 2.46x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Dell Children's Medical Center is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 2.46x the Medicare baseline. Located in 4900 Mueller Blvd, Austin, TX.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$26

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: $166 (1572%)

Insurance Median: $26 (246%)

Cash: $166 (1572% of Medicare)

Ins. Median: $26 (246% 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 246% of the Medicare baseline (a markup of 146%). 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
Ambetter / Centene	$9 - $12	85%
Blue Cross Blue Shield	$9 - $50	85%
Dell Chip/Chip Perinate	$9 - $11	85%
Dell Star	$9	85%
UnitedHealthcare	$9	85%
Wellpoint Chip/Chip Perinate	$9 - $11	85%
Wellpoint Star	$9 - $11	85%
Wellpoint Star Kids	$9	85%
Wellpoint Star Plus	$9 - $11	85%
Champva	$13 - $14	123%
Humana	$17	161%
Cigna	$25	237%
Seton Performance Plus	$26	246%
Aetna	$28 - $79	265%
Covenant Health	$58	549%
Superior Star	$84 - $106	795%
Superior Star Foster	$84 - $106	795%
Superior Star Kids	$84 - $106	795%
Superior Star Plus	$84 - $106	795%
Superior Chip/Chip Perinate	$94 - $119	890%

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 $166.
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 Dell Children's Medical Center 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.