CMS Price Transparency Data

X-ray, pelvis

Facility: Rio Grande Regional Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $521
Cash Discount Price: $1,284
vs. Medicare Baseline: 4.88x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Rio Grande Regional Hospital is $521. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,284. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.88x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.

Cash / Self-Pay

$1,284

Average discount available for prompt cash payment at this facility.

Insurance Median

$521

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $1,284 (1202%)

Insurance Median: $521 (488%)

Cash: $1,284 (1202% of Medicare)

Ins. Median: $521 (488% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 488% of the Medicare baseline (a markup of 388%). 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	$28	26%
Driscoll Children'S Health Plan	$29	27%
United	$29 - $611	27%
Aetna	$30	28%
Molina Healthcare	$31	29%
Superior Health Plan	$85 - $95	80%
Humana	$95	89%
Blue Cross Blue Shield	$253 - $611	237%
Texas Workforce Commission	$291 - $326	272%
Healthcare Highways	$309 - $346	289%
Averde Health	$400 - $448	374%
Allegian Health	$485 - $543	454%
Curative Administrators	$485 - $543	454%
Healthsmart Preferred Care	$521 - $1,154	488%
Cigna	$626 - $838	586%
First Health	$697 - $780	653%
National Healthcare Solutions	$727 - $814	681%
Southwest Medical	$727 - $814	681%
Coastal Comp	$787 - $882	737%
Usa Managed Care	$787 - $1,086	737%
Ppo Next/ Medical Control	$909 - $1,018	851%
Beech Street	$969 - $1,086	907%
Multiplan	$969 - $1,086	907%

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 $1,284.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72170.

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 72170.
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.