CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Texas Health Presbyterian Hospital Flower Mound

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $380
Cash Discount Price: $384
vs. Medicare Baseline: 35.98x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Texas Health Presbyterian Hospital Flower Mound is $380. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $384. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 35.98x the Medicare baseline. Located in 4400 Long Prairie Road, Flower Mound, TX.

Cash / Self-Pay

$384

Average discount available for prompt cash payment at this facility.

Insurance Median

$380

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: $384 (3636%)

Insurance Median: $380 (3598%)

Cash: $384 (3636% of Medicare)

Ins. Median: $380 (3598% 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 3598% of the Medicare baseline (a markup of 3498%). 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	$9 - $11	85%
Blue Cross Blue Shield	$9 - $62	85%
Cook Childrens	$9	85%
Superior Wellcare	$9 - $12	85%
UnitedHealthcare	$9 - $12	85%
Aetna	$10 - $458	95%
Molina	$10 - $11	95%
American Health	$11	104%
Healthspring	$11	104%
Humana	$11	104%
Fort Worth Firefighters	$21 - $399	199%
Cigna	$43 - $614	407%
City Of Fort Worth	$295 - $307	2794%
Quick Trip	$377 - $411	3570%
Phcs	$436 - $486	4129%
Healthsmart	$471 - $549	4460%
Multiplan	$546 - $568	5170%
Galaxy	$552 - $575	5227%
Usa	$552 - $575	5227%

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 $384.
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 Health Presbyterian Hospital Flower Mound 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.