CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Hospital Pavia Hato Rey, Inc

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74176
Insurance Median: $143
Cash Discount Price: $937
vs. Medicare Baseline: 0.59x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Hospital Pavia Hato Rey, Inc is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $937. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 0.59x the Medicare baseline. Located in Ave Ponce De Leon 435, Hato Rey, PR.

Cash / Self-Pay

$937

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $937 (384%)

Insurance Median: $143 (59%)

Cash: $937 (384% of Medicare)

Ins. Median: $143 (59% 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
First Medical	$68 - $162	28%
Mso	$81 - $113	33%
Plan De Salud Menonita	$82 - $150	34%
Fondo Del Seguro Estado	$103	42%
Va	$115	47%
Triple S	$116 - $225	48%
Mcs	$126 - $142	52%
Auxilio Salud Plus	$142	58%
Plan Socios Auxilio	$142	58%
Humana	$152 - $206	62%
Mapfre	$200	82%
Bl	$225	92%
Prossam	$225	92%

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 $937.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74176.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hospital Pavia Hato Rey, Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74176.
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.