CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Rio Grande Regional Hospital

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $2,265
Cash Discount Price: $17,038
vs. Medicare Baseline: 6.35x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Rio Grande Regional Hospital is $2,265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17,038. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 6.35x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.

Cash / Self-Pay

$17,038

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,265

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $17,038 (4780%)

Insurance Median: $2,265 (635%)

Cash: $17,038 (4780% of Medicare)

Ins. Median: $2,265 (635% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 635% of the Medicare baseline (a markup of 535%). 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	$325	91%
Driscoll Children'S Health Plan	$338	95%
United	$339 - $7,667	95%
Aetna	$359 - $3,090	101%
Molina Healthcare	$361	101%
Humana	$1,135	318%
Superior Health Plan	$1,193	335%
Blue Cross Blue Shield	$1,428 - $7,667	401%
Texas Workforce Commission	$4,089	1147%
Averde Health	$5,622	1577%
Healthsmart Preferred Care	$7,326 - $14,482	2055%
First Health	$9,797	2749%
National Healthcare Solutions	$10,223	2868%
Southwest Medical	$10,223	2868%
Coastal Comp	$11,074	3107%
Ppo Next/ Medical Control	$12,778	3585%
Beech Street	$13,630	3824%
Multiplan	$13,630	3824%
Usa Managed Care	$13,630	3824%

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 $17,038.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

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 70553.
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.