CMS Price Transparency Data

MRI, brain (no contrast)

Facility: Sweeny Community Hospital

Billing Code: 70551 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70551
  • Insurance Median: $1,010
  • Cash Discount Price: $965
  • vs. Medicare Baseline: 4.14x Medicare
The contracted insurance negotiated median rate for a MRI, brain (no contrast) at Sweeny Community Hospital is $1,010. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $965. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 4.14x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.
Cash / Self-Pay
$965

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,010

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $965 (396%)
Insurance Median: $1,010 (414%)
Cash: $965 (396% of Medicare)
Ins. Median: $1,010 (414% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 414% of the Medicare baseline (a markup of 314%). 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 $443 - $870 182%
Aetna $650 - $1,010 267%
Humana $700 - $930 287%
Evercare Mcaid $738 - $870 303%
UnitedHealthcare $797 - $1,393 327%
Amerigroup Mcr Adv - All Other Plans $856 - $1,010 351%
Community Hlth Choice Him - All Other Plans $856 - $1,010 351%
Coventry Mcr Adv $856 - $1,010 351%
Molina Mcr Adv - All Other Plans $856 - $1,010 351%
Superior Hp Mcr Adv-All Other Plans $856 - $1,010 351%
Wellcare Mcare - All Plans $856 - $1,010 351%
Care Improvement Mcr - All Plans $865 - $1,020 355%
Choicecare Mcr Adv - All Plans $865 - $1,020 355%
Cigna $950 390%
Community Hlth Choice Star $1,042 - $1,229 427%
Molina Mcaid $1,042 - $1,229 427%
Superior Hp Mcaid $1,042 - $1,229 427%
Tx Chlidrens Hp Mcaid - All Plans $1,042 - $1,229 427%
Tx True Choice Mcaid - All Plans $1,042 - $1,229 427%
Beech Street - All Plans $1,107 - $1,306 454%
Community Care Network - All Plans $1,181 - $1,393 484%
Galaxy Health Network - All Plans $1,328 - $1,567 545%
Multiplan - All Plans $1,328 - $1,567 545%
Evercare Mcr Adv - All Other Plans $1,432 - $1,688 587%
Amerigroup Mcaid $1,476 - $1,741 605%

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