CMS Price Transparency Data

CT scan, sinuses

Facility: Hospital Perea

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $133
Cash Discount Price: $315
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Hospital Perea is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $315. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 15 Dr Basora Street, Mayaguez, PR.

Cash / Self-Pay

$315

Average discount available for prompt cash payment at this facility.

Insurance Median

$133

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: $315 (295%)

Insurance Median: $133 (125%)

Cash: $315 (295% of Medicare)

Ins. Median: $133 (125% 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.

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
First Medical	$38 - $162	36%
Va	$44	41%
Mso	$50 - $70	47%
Plan De Salud Menonita	$50 - $300	47%
Ch	$68	64%
Mcs	$68 - $112	64%
Medicare (plans)	$69	65%
Tricare	$71	66%
Triple S	$99 - $124	93%
Prossam	$133	125%
Humana	$138 - $241	129%
Cigna	$139	130%
Comerciales	$150	140%
Mapfre	$150	140%
Mc	$150	140%
Acaa	$164	154%
Bella Vista	$200	187%
Privado	$265	248%
Aarp	$275	257%
Bl	$275	257%

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 $315.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70486.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hospital Perea is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70486.
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.