CMS Price Transparency Data

Blood antibody screen

Facility: Sweeny Community Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $121
  • Cash Discount Price: $124
  • vs. Medicare Baseline: 2.27x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Sweeny Community Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.27x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.
Cash / Self-Pay
$124

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)
Cash / Self-Pay: $124 (233%)
Insurance Median: $121 (227%)
Cash: $124 (233% of Medicare)
Ins. Median: $121 (227% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 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 227% of the Medicare baseline (a markup of 127%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $20 - $119 38%
Blue Cross Blue Shield $62 - $103 116%
Evercare Mcaid $103 193%
UnitedHealthcare $111 - $165 208%
Amerigroup Mcr Adv - All Other Plans $119 224%
Community Hlth Choice Him - All Other Plans $119 224%
Coventry Mcr Adv $119 224%
Molina Mcr Adv - All Other Plans $119 224%
Superior Hp Mcr Adv-All Other Plans $119 224%
Wellcare Mcare - All Plans $119 224%
Care Improvement Mcr - All Plans $121 227%
Choicecare Mcr Adv - All Plans $121 227%
Cigna $134 252%
Community Hlth Choice Star $145 272%
Molina Mcaid $145 272%
Superior Hp Mcaid $145 272%
Tx Chlidrens Hp Mcaid - All Plans $145 272%
Tx True Choice Mcaid - All Plans $145 272%
Beech Street - All Plans $154 289%
Community Care Network - All Plans $165 310%
Galaxy Health Network - All Plans $185 347%
Multiplan - All Plans $185 347%
Evercare Mcr Adv - All Other Plans $200 376%
Amerigroup Mcaid $206 387%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 305 North McKinney, Sweeny, TX 77480
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals