CMS Price Transparency Data

CT scan, sinuses

Facility: Sweeny Community Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $915
  • Cash Discount Price: $946
  • vs. Medicare Baseline: 8.57x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Sweeny Community Hospital is $915. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $946. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.57x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.
Cash / Self-Pay
$946

Average discount available for prompt cash payment at this facility.

Insurance Median
$915

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $946 (886%)
Insurance Median: $915 (857%)
Cash: $946 (886% of Medicare)
Ins. Median: $915 (857% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 857% of the Medicare baseline (a markup of 757%). 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
Blue Cross Blue Shield $473 - $788 443%
Humana $500 - $618 468%
UnitedHealthcare $500 - $1,262 468%
Aetna $515 - $915 482%
Cigna $750 702%
Evercare Mcaid $788 738%
Amerigroup Mcr Adv - All Other Plans $915 857%
Community Hlth Choice Him - All Other Plans $915 857%
Coventry Mcr Adv $915 857%
Molina Mcr Adv - All Other Plans $915 857%
Superior Hp Mcr Adv-All Other Plans $915 857%
Wellcare Mcare - All Plans $915 857%
Care Improvement Mcr - All Plans $924 865%
Choicecare Mcr Adv - All Plans $924 865%
Community Hlth Choice Star $1,113 1042%
Molina Mcaid $1,113 1042%
Superior Hp Mcaid $1,113 1042%
Tx Chlidrens Hp Mcaid - All Plans $1,113 1042%
Tx True Choice Mcaid - All Plans $1,113 1042%
Beech Street - All Plans $1,183 1108%
Community Care Network - All Plans $1,262 1182%
Galaxy Health Network - All Plans $1,419 1329%
Multiplan - All Plans $1,419 1329%
Evercare Mcr Adv - All Other Plans $1,530 1432%
Amerigroup Mcaid $1,577 1476%

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