CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Rio Grande Regional Hospital

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $8
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Rio Grande Regional Hospital is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 1.03x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$7.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $7.77 (100%)
Insurance Median: $8 (103%)
Ins. Median: $8 (103% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $7.77 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.

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
Texas Health Network $6 77%
Aetna $7 - $8 90%
Driscoll Children'S Health Plan $7 90%
Molina Healthcare $7 - $19 90%
United $7 - $8 90%
Allegian Health $8 103%
American Health Plan $8 103%
Blue Cross Blue Shield $8 - $24 103%
Cigna $8 - $28 103%
Humana $8 - $27 103%
Independent Medical System $8 103%
Molina $8 103%
Physicians Health Choice $8 103%
Prominence Health $8 103%
Provider Partners Health Plan Of Texas $8 103%
Shared Health $8 103%
Superior Health Plan $8 103%
Triwest Health Alliance $8 103%
Triwest Healthcare Alliance $8 103%
Wellmed $8 103%
Universal Health Care $9 116%
Superior $12 154%
Corvel Corporation $15 193%
Focus Healthcare $16 206%
Omni Healthcare $16 206%
Oscar $18 232%
Healthcare Highways $23 296%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 E Ridge Rd, McAllen, TX 78503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals