CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Hospital Pavia Arecibo

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $228
Cash Discount Price: $532
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Hospital Pavia Arecibo is $228. 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 $243.77, this hospital’s rate is 0.94x 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

$228

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)

Cash / Self-Pay: $532 (218%)

Insurance Median: $228 (94%)

Cash: $532 (218% of Medicare)

Ins. Median: $228 (94% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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)	$72	30%
First Medical	$73 - $325	30%
Plan Auxilio Mutuo	$73	30%
Plan De Salud Menonita	$73 - $317	30%
Mso	$90 - $98	37%
Mc	$103	42%
Comerciales	$105	43%
Ch	$149	61%
Humana	$149 - $406	61%
Mcs	$149 - $325	61%
Tricare	$149	61%
Triple S	$149 - $325	61%
Va	$149	61%
Prossam	$193	79%
Fondo Del Seguro Estado	$228	94%
Hospicio	$234	96%
Cigna	$249	102%
Auxilio Platino	$296	121%
Bl	$325	133%
Corecare	$325	133%
Privado	$325	133%
Acaa	$387	159%
Aarp	$650	267%
Mapfre	$650	267%

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: 72148.

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 72148.
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.