CMS Price Transparency Data

Blood test, hemoglobin

Facility: Sweeny Community Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $30
  • Cash Discount Price: $28
  • vs. Medicare Baseline: 12.66x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Sweeny Community Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 12.66x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.
Cash / Self-Pay
$28

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2.37

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2.37 (100%)
Cash / Self-Pay: $28 (1181%)
Insurance Median: $30 (1266%)
Cash: $28 (1181% of Medicare)
Ins. Median: $30 (1266% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2.37 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 1266% of the Medicare baseline (a markup of 1166%). 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 $1 - $30 42%
Blue Cross Blue Shield $13 - $26 549%
Evercare Mcaid $21 - $26 886%
UnitedHealthcare $23 - $41 970%
Amerigroup Mcr Adv - All Other Plans $24 - $30 1013%
Community Hlth Choice Him - All Other Plans $24 - $30 1013%
Coventry Mcr Adv $24 - $30 1013%
Molina Mcr Adv - All Other Plans $24 - $30 1013%
Superior Hp Mcr Adv-All Other Plans $24 - $30 1013%
Wellcare Mcare - All Plans $24 - $30 1013%
Care Improvement Mcr - All Plans $25 - $30 1055%
Choicecare Mcr Adv - All Plans $25 - $30 1055%
Cigna $27 - $33 1139%
Community Hlth Choice Star $30 - $36 1266%
Molina Mcaid $30 - $36 1266%
Superior Hp Mcaid $30 - $36 1266%
Tx Chlidrens Hp Mcaid - All Plans $30 - $36 1266%
Tx True Choice Mcaid - All Plans $30 - $36 1266%
Beech Street - All Plans $32 - $39 1350%
Community Care Network - All Plans $34 - $41 1435%
Galaxy Health Network - All Plans $38 - $46 1603%
Multiplan - All Plans $38 - $46 1603%
Evercare Mcr Adv - All Other Plans $41 - $50 1730%
Amerigroup Mcaid $42 - $52 1772%

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