CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Rio Grande Regional Hospital

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $3,042
Cash Discount Price: $14,753
vs. Medicare Baseline: 16.98x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Rio Grande Regional Hospital is $3,042. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,753. Compared to the federal Medicare reimbursement reference rate of $179.2, this hospital’s rate is 16.98x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.

Cash / Self-Pay

$14,753

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,042

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: $14,753 (8233%)

Insurance Median: $3,042 (1698%)

Cash: $14,753 (8233% of Medicare)

Ins. Median: $3,042 (1698% 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 1698% of the Medicare baseline (a markup of 1598%). 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	$151	84%
United	$156 - $7,016	87%
Driscoll Children'S Health Plan	$157	88%
Aetna	$166 - $2,476	93%
Molina Healthcare	$168	94%
Humana	$490	273%
Blue Cross Blue Shield	$682 - $7,016	381%
Superior Health Plan	$974 - $1,091	544%
Texas Workforce Commission	$3,340 - $3,742	1864%
Averde Health	$4,592 - $5,145	2563%
Healthsmart Preferred Care	$5,984 - $13,252	3339%
First Health	$8,002 - $8,965	4465%
National Healthcare Solutions	$8,350 - $9,354	4660%
Southwest Medical	$8,350 - $9,354	4660%
Coastal Comp	$9,045 - $10,134	5047%
Ppo Next/ Medical Control	$10,437 - $11,693	5824%
Beech Street	$11,133 - $12,472	6213%
Multiplan	$11,133 - $12,472	6213%
Usa Managed Care	$11,133 - $12,472	6213%

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 $14,753.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70460.

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 70460.
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.