CMS Price Transparency Data

Culture, bacterial

Facility: Rio Grande Regional Hospital

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $17
  • Cash Discount Price: $1,092
  • vs. Medicare Baseline: 1.97x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Rio Grande Regional Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,092. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 1.97x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$1,092

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.62

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.62 (100%)
Cash / Self-Pay: $1,092 (12668%)
Insurance Median: $17 (197%)
Cash: $1,092 (12668% of Medicare)
Ins. Median: $17 (197% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.62 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
United $1 - $620 12%
Averde Health $2 - $455 23%
Texas Workforce Commission $2 - $331 23%
Allegian Health $3 - $551 35%
Blue Cross Blue Shield $3 - $620 35%
Healthsmart Preferred Care $3 - $1,171 35%
Coastal Comp $4 - $895 46%
First Health $4 - $792 46%
National Healthcare Solutions $4 - $826 46%
Southwest Medical $4 - $826 46%
Usa Managed Care $4 - $1,102 46%
Beech Street $5 - $1,102 58%
Multiplan $5 - $1,102 58%
Ppo Next/ Medical Control $5 - $1,033 58%
Driscoll Children'S Health Plan $7 81%
Texas Health Network $7 81%
Aetna $8 - $9 93%
Molina Healthcare $8 - $21 93%
Wellmed $8 93%
American Health Plan $9 104%
Cigna $9 - $31 104%
Humana $9 - $30 104%
Independent Medical System $9 104%
Molina $9 104%
Physicians Health Choice $9 104%
Prominence Health $9 104%
Provider Partners Health Plan Of Texas $9 104%
Shared Health $9 104%
Superior Health Plan $9 - $96 104%
Triwest Health Alliance $9 104%
Triwest Healthcare Alliance $9 104%
Universal Health Care $10 116%
Superior $13 151%
Corvel Corporation $17 197%
Focus Healthcare $17 197%
Omni Healthcare $18 209%
Oscar $20 232%
Healthcare Highways $26 302%

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