CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Hospital Pavia Arecibo

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $261
Cash Discount Price: $532
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Hospital Pavia Arecibo is $261. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $532. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.73x the Medicare baseline. Located in Carretera 129 Km.1 Avenida San Luis, Arecibo, PR.

Cash / Self-Pay

$532

Average discount available for prompt cash payment at this facility.

Insurance Median

$261

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)

Cash / Self-Pay: $532 (149%)

Insurance Median: $261 (73%)

Cash: $532 (149% of Medicare)

Ins. Median: $261 (73% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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.

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
Medicare (plans)	$111	31%
First Medical	$130 - $325	36%
Plan Auxilio Mutuo	$130	36%
Plan De Salud Menonita	$130 - $317	36%
Mso	$159 - $160	45%
Mc	$184	52%
Comerciales	$185	52%
Prossam	$228	64%
Triple S	$250 - $325	70%
Ch	$261	73%
Humana	$261 - $425	73%
Mcs	$261 - $346	73%
Tricare	$261	73%
Va	$261	73%
Fondo Del Seguro Estado	$275	77%
Cigna	$302	85%
Bl	$325	91%
Corecare	$325	91%
Privado	$325	91%
Hospicio	$358	100%
Auxilio Platino	$453	127%
Mapfre	$650	182%
Aarp	$1,300	365%
Acaa	$1,300	365%

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 $532.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70553.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hospital Pavia Arecibo is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70553.
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.