CMS Price Transparency Data

Heart stent placement (inpatient stay)

Facility: Rio Grande Regional Hospital

Billing Code: 322 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 322
  • Insurance Median: $19,054
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a Heart stent placement (inpatient stay) at Rio Grande Regional Hospital is $19,054. 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 $12,807.1, this hospital’s rate is 1.49x 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
$19,054

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$12,807.1

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $12,807.1 (100%)
Insurance Median: $19,054 (149%)
Ins. Median: $19,054 (149% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $12,807.1 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
First Health $2,258 - $2,346 18%
United $3,025 - $56,317 24%
Allegian Health $14,809 - $18,681 116%
Humana $17,840 - $26,738 139%
Aetna $18,438 - $53,610 144%
Cigna $18,494 - $55,257 144%
Blue Cross Blue Shield $18,681 146%
Texas Healthcare Foundation $18,681 146%
Triwest Healthcare Alliance $18,681 146%
Wellmed $18,755 146%
Provider Partners Health Plan Of Texas $19,054 149%
American Health Plan $19,615 153%
Physicians Health Choice $19,615 153%
Prominence Health $19,615 153%
Superior Health Plan $19,615 153%
Texas Independent Health Plan $19,615 153%
Shared Health $19,988 156%
Universal Health Care $20,175 158%
Molina $20,362 159%
Oscar $21,949 171%
Curative Administrators $24,061 188%
Independent Medical System $24,567 192%
Corvel Corporation $26,446 206%
Focus Healthcare $26,713 209%
Molina Healthcare $27,938 218%
Omni Healthcare $28,049 219%
Superior $28,955 226%

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