CMS Price Transparency Data

X-ray, shoulder

Facility: Rio Grande Regional Hospital

Billing Code: 73030 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73030
Insurance Median: $646
Cash Discount Price: $1,616
vs. Medicare Baseline: 7.27x Medicare

The contracted insurance negotiated median rate for a X-ray, shoulder at Rio Grande Regional Hospital is $646. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,616. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 7.27x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.

Cash / Self-Pay

$1,616

Average discount available for prompt cash payment at this facility.

Insurance Median

$646

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: $1,616 (1818%)

Insurance Median: $646 (727%)

Cash: $1,616 (1818% of Medicare)

Ins. Median: $646 (727% 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 727% of the Medicare baseline (a markup of 627%). 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	$35	39%
United	$35 - $990	39%
Driscoll Children'S Health Plan	$36	40%
Aetna	$38	43%
Molina Healthcare	$39	44%
Humana	$88	99%
Superior Health Plan	$101 - $154	114%
Blue Cross Blue Shield	$180 - $990	202%
Texas Workforce Commission	$347 - $528	390%
Healthcare Highways	$368 - $561	414%
Cigna	$446 - $596	502%
Averde Health	$477 - $726	536%
Allegian Health	$578 - $880	650%
Curative Administrators	$578 - $880	650%
Healthsmart Preferred Care	$621 - $1,871	698%
First Health	$830 - $1,266	934%
National Healthcare Solutions	$867 - $1,321	975%
Southwest Medical	$867 - $1,321	975%
Coastal Comp	$939 - $1,431	1056%
Usa Managed Care	$939 - $1,761	1056%
Ppo Next/ Medical Control	$1,083 - $1,651	1218%
Beech Street	$1,155 - $1,761	1299%
Multiplan	$1,155 - $1,761	1299%

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 $1,616.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73030.

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 73030.
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.