CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Memorial Hermann Houston Physicians Hospital

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80053
Insurance Median: $17,845
Cash Discount Price: $10,001
vs. Medicare Baseline: 1689.87x Medicare

The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Memorial Hermann Houston Physicians Hospital is $17,845. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $10,001. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1689.87x the Medicare baseline. Located in 333 N Texas Avenue, Suite 1000, Webster, TX.

Cash / Self-Pay

$10,001

Average discount available for prompt cash payment at this facility.

Insurance Median

$17,845

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: $10,001 (94706%)

Insurance Median: $17,845 (168987%)

Cash: $10,001 (94706% of Medicare)

Ins. Median: $17,845 (168987% 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 168987% of the Medicare baseline (a markup of 168887%). 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
Aetna	$9 - $32,046	85%
Health Smart	$372	3523%
American National Insurance	$372	3523%
Cigna	$372 - $39,448	3523%
Blue Cross Blue Shield	$17,845 - $19,630	168987%
Coventry Health Care - McR	$17,845	168987%
United Teachers Association	$17,845	168987%
Unicare-McR Replacement	$17,845	168987%
Aarp	$17,845	168987%
Advantra Freedom McR Replace	$17,845	168987%
Gpa	$17,845	168987%
UnitedHealthcare	$17,845 - $19,630	168987%
Wellcare	$17,845	168987%
Banker Life and Casualty	$17,845	168987%
Advantra Freedom	$17,845	168987%
Health Spring	$17,845	168987%
Kelseycare Advantage	$17,845	168987%
Kelsey-Seybold	$17,845	168987%
Tricare	$17,845	168987%
Texan Plus	$17,845	168987%
Humana	$17,845 - $19,630	168987%
Pffs	$17,845	168987%
Devoted Health	$17,845	168987%
Medicare (plans)	$17,845	168987%
Champva	$19,630	185890%
Other	$19,630	185890%
Texas Health Spring	$19,630	185890%

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 $10,001.
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 Memorial Hermann Houston Physicians 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.