CMS Price Transparency Data

Blood test, sodium

Facility: Rio Grande Regional Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $7
  • Cash Discount Price: $721
  • vs. Medicare Baseline: 1.46x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Rio Grande Regional Hospital is $7. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $721. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 1.46x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$721

Average discount available for prompt cash payment at this facility.

Insurance Median
$7

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.81 (100%)
Cash / Self-Pay: $721 (14990%)
Insurance Median: $7 (146%)
Cash: $721 (14990% of Medicare)
Ins. Median: $7 (146% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.81 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.

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 $4 - $5 83%
Driscoll Children'S Health Plan $4 83%
Molina Healthcare $4 - $12 83%
Texas Health Network $4 83%
United $4 - $325 83%
Allegian Health $5 - $289 104%
American Health Plan $5 104%
Blue Cross Blue Shield $5 - $325 104%
Cigna $5 - $18 104%
Humana $5 - $17 104%
Independent Medical System $5 104%
Molina $5 104%
Physicians Health Choice $5 104%
Prominence Health $5 104%
Provider Partners Health Plan Of Texas $5 104%
Shared Health $5 104%
Superior Health Plan $5 - $50 104%
Triwest Health Alliance $5 104%
Triwest Healthcare Alliance $5 104%
Wellmed $5 104%
Universal Health Care $6 125%
Superior $7 146%
Corvel Corporation $10 208%
Focus Healthcare $10 208%
Omni Healthcare $10 208%
Oscar $11 229%
Healthcare Highways $14 291%
Texas Workforce Commission $173 3597%
Averde Health $238 4948%
Healthsmart Preferred Care $310 - $613 6445%
First Health $415 8628%
National Healthcare Solutions $433 9002%
Southwest Medical $433 9002%
Coastal Comp $469 9751%
Usa Managed Care $469 - $577 9751%
Ppo Next/ Medical Control $541 11247%
Beech Street $577 11996%
Multiplan $577 11996%

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