CMS Price Transparency Data

Blood test, hemoglobin

Facility: Rio Grande Regional Hospital

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $3
  • Cash Discount Price: $306
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Rio Grande Regional Hospital is $3. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $306. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 1.27x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$306

Average discount available for prompt cash payment at this facility.

Insurance Median
$3

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2.37

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2.37 (100%)
Cash / Self-Pay: $306 (12911%)
Insurance Median: $3 (127%)
Cash: $306 (12911% of Medicare)
Ins. Median: $3 (127% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2.37 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
Aetna $2 84%
Allegian Health $2 - $122 84%
American Health Plan $2 84%
Blue Cross Blue Shield $2 - $137 84%
Cigna $2 - $9 84%
Driscoll Children'S Health Plan $2 84%
Humana $2 - $8 84%
Independent Medical System $2 84%
Molina Healthcare $2 - $6 84%
Physicians Health Choice $2 84%
Prominence Health $2 84%
Shared Health $2 84%
Superior Health Plan $2 - $21 84%
Texas Health Network $2 84%
Triwest Healthcare Alliance $2 84%
United $2 - $137 84%
Wellmed $2 84%
Molina $3 127%
Provider Partners Health Plan Of Texas $3 127%
Triwest Health Alliance $3 127%
Universal Health Care $3 127%
Superior $4 169%
Corvel Corporation $5 211%
Focus Healthcare $5 211%
Omni Healthcare $5 211%
Oscar $6 253%
Healthcare Highways $7 295%
Texas Workforce Commission $73 3080%
Averde Health $101 4262%
Healthsmart Preferred Care $131 - $260 5527%
First Health $176 7426%
National Healthcare Solutions $183 7722%
Southwest Medical $183 7722%
Coastal Comp $199 8397%
Usa Managed Care $199 - $244 8397%
Ppo Next/ Medical Control $229 9662%
Beech Street $244 10295%
Multiplan $244 10295%

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