CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $675
Cash Discount Price: $715
vs. Medicare Baseline: 63.92x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Texas Childrens Hospital North Austin Campus is $675. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $715. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 63.92x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$715

Average discount available for prompt cash payment at this facility.

Insurance Median

$675

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: $715 (6771%)

Insurance Median: $675 (6392%)

Cash: $715 (6771% of Medicare)

Ins. Median: $675 (6392% 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 6392% of the Medicare baseline (a markup of 6292%). 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	$11	104%
Driscoll Children'S Health Plan Mcd	$12	114%
Community Health Choice	$18 - $691	170%
First Care Health Plan	$285 - $691	2699%
UnitedHealthcare	$285 - $691	2699%
Molina Mcd	$316 - $324	2992%
Blue Cross Blue Shield	$369 - $680	3494%
Community First Health Plan Mcd	$422 - $432	3996%
Cook Children'S Health Plan	$422 - $432	3996%
Cigna	$601 - $691	5691%
Aetna	$675 - $691	6392%
Kelseycare	$685 - $701	6487%
Healthsmart	$738 - $755	6989%
Evolutions Healthcare	$790 - $809	7481%
First Health	$928 - $1,025	8788%
Multiplan	$949 - $971	8987%
Galaxy Health Network	$1,001 - $1,025	9479%

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 $715.
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 Texas Childrens Hospital North Austin Campus 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.