CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Rio Grande Regional Hospital

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $2,265
Cash Discount Price: $13,516
vs. Medicare Baseline: 9.29x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no 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 $13,516. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 9.29x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.

Cash / Self-Pay

$13,516

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

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $13,516 (5545%)

Insurance Median: $2,265 (929%)

Cash: $13,516 (5545% of Medicare)

Ins. Median: $2,265 (929% 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 929% of the Medicare baseline (a markup of 829%). 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	$195	80%
Driscoll Children'S Health Plan	$203	83%
United	$203 - $6,082	83%
Aetna	$215 - $3,090	88%
Molina Healthcare	$217	89%
Humana	$675	277%
Blue Cross Blue Shield	$872 - $6,082	358%
Superior Health Plan	$946	388%
Texas Workforce Commission	$3,244	1331%
Averde Health	$4,460	1830%
Healthsmart Preferred Care	$5,812 - $11,489	2384%
First Health	$7,772	3188%
National Healthcare Solutions	$8,110	3327%
Southwest Medical	$8,110	3327%
Coastal Comp	$8,786	3604%
Ppo Next/ Medical Control	$10,137	4158%
Beech Street	$10,813	4436%
Multiplan	$10,813	4436%
Usa Managed Care	$10,813	4436%

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 $13,516.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72148.

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 72148.
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.