CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $422
Cash Discount Price: $446
vs. Medicare Baseline: 49.88x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Texas Childrens Hospital North Austin Campus is $422. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $446. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 49.88x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$446

Average discount available for prompt cash payment at this facility.

Insurance Median

$422

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: $446 (5272%)

Insurance Median: $422 (4988%)

Cash: $446 (5272% of Medicare)

Ins. Median: $422 (4988% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 4988% of the Medicare baseline (a markup of 4888%). 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
Superior Chip	$8 - $9	95%
Driscoll Children'S Health Plan Mcd	$9	106%
Community Health Choice	$15 - $426	177%
First Care Health Plan	$180 - $426	2128%
UnitedHealthcare	$180 - $426	2128%
Molina Mcd	$200	2364%
Blue Cross Blue Shield	$233 - $419	2754%
Community First Health Plan Mcd	$266	3144%
Cook Children'S Health Plan	$266	3144%
Cigna	$379 - $426	4480%
Aetna	$426	5035%
Kelseycare	$432	5106%
Healthsmart	$466	5508%
Evolutions Healthcare	$499	5898%
First Health	$585 - $632	6915%
Multiplan	$598	7069%
Galaxy Health Network	$632	7470%

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 $446.
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 Texas Childrens Hospital North Austin Campus 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.