CMS Price Transparency Data

Blood test, PSA (prostate screen)

Facility: Sweeny Community Hospital

Billing Code: 84153 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84153
  • Insurance Median: $116
  • Cash Discount Price: $112
  • vs. Medicare Baseline: 6.31x Medicare
The contracted insurance negotiated median rate for a Blood test, PSA (prostate screen) at Sweeny Community Hospital is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $18.39, this hospital’s rate is 6.31x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.
Cash / Self-Pay
$112

Average discount available for prompt cash payment at this facility.

Insurance Median
$116

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$18.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $18.39 (100%)
Cash / Self-Pay: $112 (609%)
Insurance Median: $116 (631%)
Cash: $112 (609% of Medicare)
Ins. Median: $116 (631% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $18.39 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 631% of the Medicare baseline (a markup of 531%). 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 $26 - $135 141%
Blue Cross Blue Shield $42 - $116 228%
Evercare Mcaid $70 - $116 381%
UnitedHealthcare $75 - $186 408%
Amerigroup Mcr Adv - All Other Plans $81 - $135 440%
Care Improvement Mcr - All Plans $81 - $136 440%
Choicecare Mcr Adv - All Plans $81 - $136 440%
Community Hlth Choice Him - All Other Plans $81 - $135 440%
Coventry Mcr Adv $81 - $135 440%
Molina Mcr Adv - All Other Plans $81 - $135 440%
Superior Hp Mcr Adv-All Other Plans $81 - $135 440%
Wellcare Mcare - All Plans $81 - $135 440%
Cigna $90 - $151 489%
Community Hlth Choice Star $98 - $164 533%
Molina Mcaid $98 - $164 533%
Superior Hp Mcaid $98 - $164 533%
Tx Chlidrens Hp Mcaid - All Plans $98 - $164 533%
Tx True Choice Mcaid - All Plans $98 - $164 533%
Beech Street - All Plans $104 - $175 566%
Community Care Network - All Plans $111 - $186 604%
Galaxy Health Network - All Plans $125 - $209 680%
Multiplan - All Plans $125 - $209 680%
Evercare Mcr Adv - All Other Plans $135 - $226 734%
Amerigroup Mcaid $139 - $233 756%

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