▸ Hospital · CO · CCN 061301
RIO GRANDE HOSPITAL
310 COUNTY ROAD 14, DEL NORTE, CO, 81132
17 bedsCritical Access Hospitals2
Compliance grade
A
100/100
Procedures tracked
94
of 209 target codes
Payers
30
with negotiated rates
Rates published
66,470
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychiatric diagnostic evaluation | CPT | 90791 | 5 | $553.3 | $110.66 | $149.12 | $149.12 | $1,000 |
| Psychiatric eval with medical services | CPT | 90792 | 4 | $614.9 | $122.98 | $169.43 | $169.43 | $1,000 |
| Psychotherapy 30 minutes | CPT | 90832 | 5 | $534.6 | $106.92 | $65.72 | $65.72 | $1,000 |
| Psychotherapy 45 minutes | CPT | 90834 | 5 | $665.5 | $133.1 | $87.11 | $87.11 | $1,000 |
| Psychotherapy 60 minutes | CPT | 90837 | 5 | $760.1 | $152.02 | $128.07 | $128.07 | $1,000 |
| Crisis psychotherapy 60 minutes | CPT | 90839 | 2 | $994.4 | $198.88 | $165.82 | $582.91 | $1,000 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 27 | $479.4 | $95.88 | $51.36 | $51.36 | $1,000 |
| ED visit level 2 | CPT | 99282 | 27 | $1,070.15 | $214.03 | $51.36 | $51.36 | $1,500 |
| ED visit level 3 | CPT | 99283 | 27 | $2,052.75 | $410.55 | $51.36 | $51.36 | $2,499 |
| ED visit level 4 | CPT | 99284 | 3 | $2,487.1 | $497.42 | $165.82 | $3,900 | $3,900 |
| ED visit level 5 | CPT | 99285 | 3 | $3,371.1 | $674.22 | $165.82 | $7,800 | $7,800 |
| Critical care, first hour | CPT | 99291 | 3 | $6,106.4 | $1,221.28 | $165.82 | $7,800 | $7,800 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 26 | $9,210.88 | $1,842.18 | $108.97 | $108.97 | $1,000 |
| CT head with contrast | CPT | 70460 | 26 | $8,663.2 | $1,732.64 | $156.38 | $156.38 | $1,000 |
| CT head with and without contrast | CPT | 70470 | 26 | $13,551 | $2,710.18 | $165.82 | $178.55 | $1,000 |
| CT neck with contrast | CPT | 70491 | 26 | $9,676.8 | $1,935.36 | $165.82 | $178.55 | $1,000 |
| MRI brain without contrast | CPT | 70551 | 26 | $6,942.88 | $1,388.58 | $165.82 | $211.18 | $1,000 |
| MRI brain with contrast | CPT | 70552 | 26 | $7,732.48 | $1,546.5 | $165.82 | $294.04 | $1,000 |
| MRI brain with and without contrast | CPT | 70553 | 26 | $16,281 | $3,256.29 | $165.82 | $347.16 | $1,000 |
| Chest X-ray single view | CPT | 71045 | 26 | $806.4 | $161.28 | $25.06 | $25.06 | $1,000 |
| Chest X-ray 2 views | CPT | 71046 | 26 | $1,095.36 | $219.07 | $32.75 | $32.75 | $1,000 |
| Chest X-ray 3 views | CPT | 71047 | 26 | $1,122.24 | $224.45 | $41.44 | $41.44 | $1,000 |
| CT chest without contrast | CPT | 71250 | 26 | $10,119 | $2,023.84 | $108.97 | $108.97 | $1,000 |
| CT chest with contrast | CPT | 71260 | 26 | $11,017 | $2,203.49 | $165.82 | $178.55 | $1,000 |
| CT chest with and without contrast | CPT | 71270 | 26 | $13,691 | $2,738.18 | $165.82 | $178.55 | $1,000 |
| MRI chest without contrast | CPT | 71550 | 26 | $6,102.88 | $1,220.58 | $165.82 | $230.13 | $1,000 |
| MRI chest with contrast | CPT | 71551 | 26 | $6,277.6 | $1,255.52 | $165.82 | $417.66 | $1,000 |
| MRI chest with and without contrast | CPT | 71552 | 26 | $16,577 | $3,315.42 | $165.82 | $368.12 | $1,000 |
| Lumbosacral spine X-ray | CPT | 72100 | 26 | $1,393.28 | $278.66 | $38.76 | $38.76 | $1,000 |
| CT cervical spine without contrast | CPT | 72125 | 26 | $10,212 | $2,042.43 | $108.97 | $108.97 | $1,000 |
| CT thoracic spine without contrast | CPT | 72128 | 26 | $10,212 | $2,042.43 | $108.97 | $108.97 | $1,000 |
| CT lumbar spine without contrast | CPT | 72131 | 26 | $10,212 | $2,042.43 | $108.97 | $108.97 | $1,000 |
| MRI cervical spine without contrast | CPT | 72141 | 26 | $8,223.04 | $1,644.61 | $165.82 | $206.49 | $1,000 |
| MRI thoracic spine without contrast | CPT | 72146 | 26 | $9,124.64 | $1,824.93 | $165.82 | $206.49 | $1,000 |
| MRI lumbar spine without contrast | CPT | 72148 | 26 | $9,124.64 | $1,824.93 | $165.82 | $206.83 | $1,000 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 26 | $6,419.84 | $1,283.97 | $165.82 | $296.38 | $1,000 |
| MRI cervical spine with and without contrast | CPT | 72156 | 26 | $16,187 | $3,237.47 | $165.82 | $350.5 | $1,000 |
| MRI lumbar spine with contrast | CPT | 72158 | 26 | $16,187 | $3,237.47 | $165.82 | $349.84 | $1,000 |
| CT pelvis without contrast | CPT | 72192 | 26 | $9,826.88 | $1,965.38 | $108.97 | $108.97 | $1,000 |
| CT pelvis with contrast | CPT | 72193 | 26 | $12,357 | $2,471.39 | $165.82 | $178.55 | $1,000 |
| Shoulder X-ray | CPT | 73030 | 26 | $1,118.88 | $223.78 | $33.41 | $33.41 | $1,000 |
| Humerus X-ray | CPT | 73060 | 26 | $885.92 | $177.18 | $31.41 | $31.41 | $1,000 |
| Hand X-ray 3 views | CPT | 73130 | 26 | $1,014.72 | $202.94 | $35.41 | $35.41 | $1,000 |
| MRI upper extremity joint without contrast | CPT | 73221 | 26 | $8,100.96 | $1,620.19 | $165.82 | $219.19 | $1,000 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 26 | $16,668 | $3,333.57 | $165.82 | $368.12 | $1,000 |
| Knee X-ray 1-2 views | CPT | 73560 | 26 | $921.76 | $184.35 | $33.41 | $33.41 | $1,000 |
| Ankle X-ray 3 views | CPT | 73610 | 26 | $1,047.2 | $209.44 | $35.75 | $35.75 | $1,000 |
| MRI lower extremity joint without contrast | CPT | 73721 | 26 | $8,100.96 | $1,620.19 | $165.82 | $218.53 | $1,000 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 26 | $15,782 | $3,156.38 | $165.82 | $368.12 | $1,000 |
| CT abdomen without contrast | CPT | 74150 | 26 | $10,377 | $2,075.36 | $108.97 | $108.97 | $1,000 |
| CT abdomen with contrast | CPT | 74160 | 26 | $11,701 | $2,340.13 | $165.82 | $178.55 | $1,000 |
| CT abdomen with and without contrast | CPT | 74170 | 26 | $15,381 | $3,076.19 | $165.82 | $178.55 | $1,000 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 26 | $20,536 | $4,107.26 | $165.82 | $192.13 | $1,000 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 26 | $19,712 | $3,942.4 | $165.82 | $324.78 | $1,000 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 26 | $30,272 | $6,054.5 | $165.82 | $364.2 | $1,000 |
| MRI abdomen without contrast | CPT | 74181 | 26 | $7,291.2 | $1,458.24 | $165.82 | $213.51 | $1,000 |
| MRI abdomen with and without contrast | CPT | 74183 | 26 | $16,704 | $3,340.74 | $165.82 | $368.12 | $1,000 |
| Abdominal ultrasound complete | CPT | 76700 | 26 | $2,786.56 | $557.31 | $108.97 | $108.97 | $1,000 |
| Abdominal ultrasound limited | CPT | 76705 | 26 | $3,017.28 | $603.46 | $89.21 | $89.21 | $1,000 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 26 | $2,766.4 | $553.28 | $108.97 | $108.97 | $1,000 |
| Pelvic ultrasound complete | CPT | 76856 | 2 | $3,424.96 | $684.99 | $165.82 | $582.91 | $1,000 |
| Scrotal ultrasound | CPT | 76870 | 26 | $2,625.28 | $525.06 | $102.91 | $102.91 | $1,000 |
| EKG tracing only | CPT | 93005 | 2 | $938.3 | $187.66 | $165.82 | $582.91 | $1,000 |
| Transthoracic echocardiogram complete | CPT | 93306 | 2 | $5,309.7 | $1,061.94 | $165.82 | $582.91 | $1,000 |
| Transthoracic echocardiogram | CPT | 93307 | 26 | $3,099.8 | $619.96 | $132.65 | $132.65 | $1,000 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 29 | $1,175.3 | $235.06 | $7.11 | $7.11 | $1,000 |
| Electrolyte panel | CPT | 80051 | 29 | $1,131.6 | $226.32 | $5.89 | $5.89 | $1,000 |
| Comprehensive metabolic panel | CPT | 80053 | 29 | $1,606.55 | $321.31 | $8.87 | $8.87 | $1,000 |
| Lipid panel | CPT | 80061 | 29 | $1,199.45 | $239.89 | $11.25 | $11.25 | $1,000 |
| Renal function panel | CPT | 80069 | 29 | $354.2 | $70.84 | $7.29 | $7.29 | $1,000 |
| Hepatic function panel | CPT | 80076 | 29 | $1,428.3 | $285.66 | $6.86 | $6.86 | $1,000 |
| Urinalysis non-automated | CPT | 81002 | 29 | $203.55 | $40.71 | $2.92 | $2.92 | $1,000 |
| Urinalysis automated | CPT | 81003 | 6 | $198.38 | $39.68 | $1.89 | $2.44 | $1,000 |
| Glucose quantitative | CPT | 82947 | 29 | $618.7 | $123.74 | $3.3 | $3.3 | $1,000 |
| Hemoglobin A1c | CPT | 83036 | 29 | $424.35 | $84.87 | $8.16 | $8.16 | $1,000 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 29 | $813.05 | $162.61 | $14.11 | $14.11 | $1,000 |
| Complete blood count with automated differential | CPT | 85025 | 29 | $286.35 | $57.27 | $6.53 | $6.53 | $1,000 |
| Complete blood count without differential | CPT | 85027 | 29 | $307.05 | $61.41 | $5.43 | $5.43 | $1,000 |
| Urine culture bacterial | CPT | 87086 | 29 | $707.25 | $141.45 | $6.78 | $6.78 | $1,000 |
| Tissue exam by pathologist level IV | CPT | 88305 | 2 | $2,768.05 | $553.61 | $165.82 | $582.91 | $1,000 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 2 | $892.1 | $178.42 | $165.82 | $582.91 | $1,000 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 2 | $1,113.2 | $222.64 | $165.82 | $582.91 | $1,000 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 2 | $1,415.7 | $283.14 | $165.82 | $582.91 | $1,000 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 2 | $1,658.8 | $331.76 | $165.82 | $582.91 | $1,000 |
| Office visit, established patient, 5 min | CPT | 99211 | 2 | $444.4 | $88.88 | $165.82 | $582.91 | $1,000 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 2 | $669.19 | $133.84 | $165.82 | $582.91 | $1,000 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 2 | $892.1 | $178.42 | $165.82 | $582.91 | $1,000 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 2 | $1,188 | $237.6 | $165.82 | $582.91 | $1,000 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 2 | $1,417.9 | $283.58 | $165.82 | $582.91 | $1,000 |
| preventive | ||||||||
| Sigmoidoscopy with biopsy | CPT | 45331 | 2 | $3,867 | $773.4 | $165.82 | $582.91 | $1,000 |
| surgery | ||||||||
| Intravitreal injection | CPT | 67028 | 2 | $3,374.8 | $674.96 | $165.82 | $582.91 | $1,000 |
| Left heart catheterization | CPT | 93452 | 3 | $14,286 | $2,857.14 | $165.82 | $7,166 | $7,166 |
| Coronary angiography with cath | CPT | 93455 | 3 | $15,089 | $3,017.74 | $165.82 | $7,166 | $7,166 |
| Coronary angiography with bypass cath | CPT | 93458 | 3 | $14,716 | $2,943.16 | $165.82 | $7,166 | $7,166 |
Payer mix (top 30)
| Payer | Codes covered | Median rate |
|---|---|---|
| police departments [50065] | 94 | $1,000 |
| texas rehabilitation comm [50038] | 93 | $165.82 |
| Blue Cross Blue Shield | 72 | $213.51 |
| point comfort underwrite inc [50215] | 67 | $108.97 |
| cook childrens health plan [50177] | 66 | $108.97 |
| dell childrens health plan [50227] | 66 | $108.97 |
| driscoll health plan non-verified [2000000002] | 66 | $108.97 |
| evercare of texas [50171] | 66 | $108.97 |
| firstcare lubbock [50191] | 66 | $108.97 |
| generic coverage mcd mgd care [50244] | 66 | $108.97 |
| Medicaid | 66 | $108.97 |
| Molina | 66 | $108.97 |
| parkland community health plan [50190] | 66 | $108.97 |
| pending tx mgd mdcd # [50242] | 66 | $108.97 |
| wellpoint amerigroup [50170] | 66 | $108.97 |
| community first plan [50184] | 66 | $108.97 |
| community health choice [50185] | 66 | $108.97 |
| community health choice [50192] | 66 | $108.97 |
| tmhp-pccm [50208] | 66 | $108.97 |
| unicare health plans of texas [50173] | 66 | $108.97 |
| UnitedHealthcare | 66 | $108.97 |
| Aetna | 66 | $108.97 |
| rightcare - scott & white health plan [50212] | 66 | $108.97 |
| texas children's health plan [50198] | 66 | $108.97 |
| texas health network [50189] | 66 | $108.97 |
| tmhp [50160] | 66 | $108.97 |
| champ va [50319] | 19 | $9.39 |
| TRICARE | 19 | $9.39 |
| triwest hc alliance [50269] | 19 | $9.39 |
| driscoll health plan [2000000001] | 3 | $51.36 |