CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Sweeny Community Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $120
Cash Discount Price: $123
vs. Medicare Baseline: 14.18x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Sweeny Community Hospital is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 14.18x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $123 (1454%)

Insurance Median: $120 (1418%)

Cash: $123 (1454% of Medicare)

Ins. Median: $120 (1418% 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 1418% of the Medicare baseline (a markup of 1318%). 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	$17 - $119	201%
Blue Cross Blue Shield	$61 - $102	721%
Evercare Mcaid	$102	1206%
UnitedHealthcare	$111 - $164	1312%
Amerigroup Mcr Adv - All Other Plans	$119	1407%
Community Hlth Choice Him - All Other Plans	$119	1407%
Coventry Mcr Adv	$119	1407%
Molina Mcr Adv - All Other Plans	$119	1407%
Superior Hp Mcr Adv-All Other Plans	$119	1407%
Wellcare Mcare - All Plans	$119	1407%
Care Improvement Mcr - All Plans	$120	1418%
Choicecare Mcr Adv - All Plans	$120	1418%
Cigna	$133	1572%
Community Hlth Choice Star	$145	1714%
Molina Mcaid	$145	1714%
Superior Hp Mcaid	$145	1714%
Tx Chlidrens Hp Mcaid - All Plans	$145	1714%
Tx True Choice Mcaid - All Plans	$145	1714%
Beech Street - All Plans	$154	1820%
Community Care Network - All Plans	$164	1939%
Galaxy Health Network - All Plans	$184	2175%
Multiplan - All Plans	$184	2175%
Evercare Mcr Adv - All Other Plans	$199	2352%
Amerigroup Mcaid	$205	2423%

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 $123.
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 Sweeny Community Hospital 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.