CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Rio Grande Regional Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $499
Cash Discount Price: $1,322
vs. Medicare Baseline: 5.61x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Rio Grande Regional Hospital is $499. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,322. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.61x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.

Cash / Self-Pay

$1,322

Average discount available for prompt cash payment at this facility.

Insurance Median

$499

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $1,322 (1487%)

Insurance Median: $499 (561%)

Cash: $1,322 (1487% of Medicare)

Ins. Median: $499 (561% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 561% of the Medicare baseline (a markup of 461%). 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	$39	44%
Driscoll Children'S Health Plan	$41	46%
United	$41 - $628	46%
Aetna	$43	48%
Molina Healthcare	$44	49%
Superior Health Plan	$87 - $98	98%
Humana	$100	112%
Blue Cross Blue Shield	$180 - $628	202%
Texas Workforce Commission	$300 - $335	337%
Healthcare Highways	$318 - $356	358%
Averde Health	$412 - $461	463%
Cigna	$446 - $596	502%
Allegian Health	$499 - $558	561%
Curative Administrators	$499 - $558	561%
Healthsmart Preferred Care	$537 - $1,187	604%
First Health	$718 - $803	808%
National Healthcare Solutions	$749 - $838	842%
Southwest Medical	$749 - $838	842%
Coastal Comp	$811 - $907	912%
Usa Managed Care	$811 - $1,117	912%
Ppo Next/ Medical Control	$936 - $1,047	1053%
Beech Street	$998 - $1,117	1122%
Multiplan	$998 - $1,117	1122%

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 $1,322.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72040.

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 72040.
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.