CMS Price Transparency Data

Blood test, liver function panel

Facility: Sweeny Community Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $124
Cash Discount Price: $127
vs. Medicare Baseline: 15.18x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Sweeny Community Hospital is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 15.18x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$124

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.17 (100%)

Cash / Self-Pay: $127 (1554%)

Insurance Median: $124 (1518%)

Cash: $127 (1554% of Medicare)

Ins. Median: $124 (1518% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.17 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 1518% of the Medicare baseline (a markup of 1418%). 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 - $122	208%
Blue Cross Blue Shield	$63 - $106	771%
Evercare Mcaid	$106	1297%
UnitedHealthcare	$114 - $169	1395%
Amerigroup Mcr Adv - All Other Plans	$122	1493%
Community Hlth Choice Him - All Other Plans	$122	1493%
Coventry Mcr Adv	$122	1493%
Molina Mcr Adv - All Other Plans	$122	1493%
Superior Hp Mcr Adv-All Other Plans	$122	1493%
Wellcare Mcare - All Plans	$122	1493%
Care Improvement Mcr - All Plans	$124	1518%
Choicecare Mcr Adv - All Plans	$124	1518%
Cigna	$137	1677%
Community Hlth Choice Star	$149	1824%
Molina Mcaid	$149	1824%
Superior Hp Mcaid	$149	1824%
Tx Chlidrens Hp Mcaid - All Plans	$149	1824%
Tx True Choice Mcaid - All Plans	$149	1824%
Beech Street - All Plans	$158	1934%
Community Care Network - All Plans	$169	2069%
Galaxy Health Network - All Plans	$190	2326%
Multiplan - All Plans	$190	2326%
Evercare Mcr Adv - All Other Plans	$205	2509%
Amerigroup Mcaid	$211	2583%

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 $127.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80076.

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 80076.
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.