CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Rio Grande Regional Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $3,067
  • Cash Discount Price: $14,872
  • vs. Medicare Baseline: 28.71x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Rio Grande Regional Hospital is $3,067. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,872. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 28.71x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$14,872

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,067

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $14,872 (13924%)
Insurance Median: $3,067 (2871%)
Cash: $14,872 (13924% of Medicare)
Ins. Median: $3,067 (2871% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 2871% of the Medicare baseline (a markup of 2771%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $104 97%
Driscoll Children'S Health Plan $108 101%
United $109 - $7,070 102%
Aetna $115 - $2,476 108%
Molina Healthcare $115 108%
Blue Cross Blue Shield $419 - $7,070 392%
Humana $553 518%
Superior Health Plan $982 - $1,100 919%
Texas Workforce Commission $3,368 - $3,771 3153%
Averde Health $4,631 - $5,185 4336%
Healthsmart Preferred Care $6,034 - $13,354 5649%
First Health $8,069 - $9,034 7555%
National Healthcare Solutions $8,420 - $9,427 7883%
Southwest Medical $8,420 - $9,427 7883%
Coastal Comp $9,122 - $10,212 8540%
Ppo Next/ Medical Control $10,525 - $11,783 9854%
Beech Street $11,227 - $12,569 10511%
Multiplan $11,227 - $12,569 10511%
Usa Managed Care $11,227 - $12,569 10511%

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