CMS Price Transparency Data

CT scan, sinuses

Facility: Rio Grande Regional Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,901
Cash Discount Price: $14,071
vs. Medicare Baseline: 27.16x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Rio Grande Regional Hospital is $2,901. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $14,071. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 27.16x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.

Cash / Self-Pay

$14,071

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,901

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: $14,071 (13174%)

Insurance Median: $2,901 (2716%)

Cash: $14,071 (13174% of Medicare)

Ins. Median: $2,901 (2716% 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 2716% of the Medicare baseline (a markup of 2616%). 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	$104	97%
Driscoll Children'S Health Plan	$108	101%
United	$109 - $6,691	102%
Aetna	$115 - $2,476	108%
Molina Healthcare	$115	108%
Humana	$417	390%
Blue Cross Blue Shield	$419 - $6,691	392%
Superior Health Plan	$929 - $1,041	870%
Texas Workforce Commission	$3,186 - $3,568	2983%
Averde Health	$4,381 - $4,907	4102%
Healthsmart Preferred Care	$5,708 - $12,638	5344%
First Health	$7,633 - $8,549	7146%
National Healthcare Solutions	$7,965 - $8,921	7457%
Southwest Medical	$7,965 - $8,921	7457%
Coastal Comp	$8,628 - $9,664	8078%
Ppo Next/ Medical Control	$9,956 - $11,151	9321%
Beech Street	$10,619 - $11,895	9942%
Multiplan	$10,619 - $11,895	9942%
Usa Managed Care	$10,619 - $11,895	9942%

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 $14,071.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70486.

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 70486.
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.