CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Rio Grande Regional Hospital

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73721
Insurance Median: $5,025
Cash Discount Price: $13,436
vs. Medicare Baseline: 20.61x Medicare

The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Rio Grande Regional Hospital is $5,025. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,436. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 20.61x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.

Cash / Self-Pay

$13,436

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,025

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $13,436 (5512%)

Insurance Median: $5,025 (2061%)

Cash: $13,436 (5512% of Medicare)

Ins. Median: $5,025 (2061% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 2061% of the Medicare baseline (a markup of 1961%). 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	$207	85%
Driscoll Children'S Health Plan	$215	88%
United	$215 - $8,245	88%
Aetna	$228 - $3,090	94%
Molina Healthcare	$230	94%
Humana	$712	292%
Superior Health Plan	$818 - $1,283	336%
Blue Cross Blue Shield	$872 - $8,245	358%
Texas Workforce Commission	$2,805 - $4,398	1151%
Averde Health	$3,857 - $6,047	1582%
Healthsmart Preferred Care	$5,025 - $15,575	2061%
First Health	$6,720 - $10,536	2757%
National Healthcare Solutions	$7,012 - $10,994	2876%
Southwest Medical	$7,012 - $10,994	2876%
Coastal Comp	$7,596 - $11,910	3116%
Ppo Next/ Medical Control	$8,765 - $13,742	3596%
Beech Street	$9,349 - $14,659	3835%
Multiplan	$9,349 - $14,659	3835%
Usa Managed Care	$9,349 - $14,659	3835%

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 $13,436.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73721.

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 73721.
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.