CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Sweeny Community Hospital

Billing Code: 99214 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$229

about 1.7× the $136 Medicare rate · typically $82–$335

modeled estimate · not a bill or quote

What this hospital charges insurers

$227

About the fair price

about $2 under the fair price · 1.7× Medicare

Medicare pays $136 Fair price $229 This hospital $227 Cash price $136 Hospital's list price $227

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $48 Priciest $227

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (30-39 min) is about $229 (about 1.7× the $136 Medicare rate). Sweeny Community Hospital charges insurers about $227, or about $136 in cash — about the fair price. Located in Sweeny, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$90 - $498	66%
Blue Cross Blue Shieldmajor	$50 - $311	37%
Aetnamajor	$86 - $498	63%
Amerigroup	$97 - $622	72%
Molina	$97 - $439	72%
WellCare	$97 - $361	72%
+ 11 smaller / regional plans	$45 - $603

Government programs also on file: Military & VA.

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 136), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99214.

Insurance Before you use insurance

Call your insurance company to confirm Sweeny Community Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 99214.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Sweeny Community Hospital

Compare: Office visit, established patient (30-39 min) at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.