CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Rio Grande Regional Hospital

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $3,569
Cash Discount Price: $17,311
vs. Medicare Baseline: 19.92x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Rio Grande Regional Hospital is $3,569. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,311. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 19.92x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.

Cash / Self-Pay

$17,311

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,569

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)

Cash / Self-Pay: $17,311 (9660%)

Insurance Median: $3,569 (1992%)

Cash: $17,311 (9660% of Medicare)

Ins. Median: $3,569 (1992% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $179.2 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 1992% of the Medicare baseline (a markup of 1892%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$173	97%
Driscoll Children'S Health Plan	$180	100%
United	$184 - $8,231	103%
Molina Healthcare	$193	108%
Aetna	$195 - $2,476	109%
Humana	$575	321%
Blue Cross Blue Shield	$682 - $8,231	381%
Superior Health Plan	$1,143 - $1,280	638%
Texas Workforce Commission	$3,919 - $4,390	2187%
Averde Health	$5,389 - $6,036	3007%
Healthsmart Preferred Care	$7,022 - $15,547	3919%
First Health	$9,390 - $10,517	5240%
National Healthcare Solutions	$9,799 - $10,975	5468%
Southwest Medical	$9,799 - $10,975	5468%
Coastal Comp	$10,615 - $11,889	5924%
Ppo Next/ Medical Control	$12,248 - $13,718	6835%
Beech Street	$13,065 - $14,633	7291%
Multiplan	$13,065 - $14,633	7291%
Usa Managed Care	$13,065 - $14,633	7291%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $17,311.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70470.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Rio Grande Regional Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70470.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.