CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Rio Grande Regional Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $10,846
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.91x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Rio Grande Regional Hospital is $10,846. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.91x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$10,846

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)
Insurance Median: $10,846 (191%)
Ins. Median: $10,846 (191% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5,675.87 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
Usa Managed Care $600 - $700 11%
Texas Athletic Network $750 13%
American Health Plan $1,275 - $11,388 22%
Oscar $2,014 - $12,084 35%
First Health $2,258 - $2,346 40%
Aetna $2,958 - $10,705 52%
United $3,060 - $10,726 54%
Allegian Health $6,549 - $10,846 115%
Blue Cross Blue Shield $10,127 - $16,396 178%
Humana $10,358 - $11,823 182%
Curative Administrators $10,640 187%
Cigna $10,737 - $15,723 189%
Texas Healthcare Foundation $10,846 191%
Triwest Healthcare Alliance $10,846 191%
Independent Medical System $10,864 191%
Wellmed $10,889 192%
Provider Partners Health Plan Of Texas $11,063 195%
Physicians Health Choice $11,388 201%
Prominence Health $11,388 201%
Superior Health Plan $11,388 201%
Texas Independent Health Plan $11,388 201%
Shared Health $11,605 204%
Universal Health Care $11,713 206%
Molina $11,822 208%
Molina Healthcare $12,354 218%
Corvel Corporation $15,354 271%
Focus Healthcare $15,509 273%
Omni Healthcare $16,285 287%
Superior $16,811 296%

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