CMS Price Transparency Data

MRI, brain (with and without contrast)

Facility: Hospital Pavia Hato Rey, Inc

Billing Code: 70553 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70553
Insurance Median: $297
Cash Discount Price: $1,788
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a MRI, brain (with and without contrast) at Hospital Pavia Hato Rey, Inc is $297. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,788. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.83x the Medicare baseline. Located in Ave Ponce De Leon 435, Hato Rey, PR.

Cash / Self-Pay

$1,788

Average discount available for prompt cash payment at this facility.

Insurance Median

$297

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: $1,788 (502%)

Insurance Median: $297 (83%)

Cash: $1,788 (502% of Medicare)

Ins. Median: $297 (83% 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
First Medical	$116 - $325	33%
Tricare	$117	33%
Mso	$136 - $160	38%
Plan De Salud Menonita	$155 - $288	43%
Fondo Del Seguro Estado	$194	54%
Mcs	$194 - $329	54%
Triple S	$194 - $492	54%
Prossam	$241	68%
Auxilio Salud Plus	$271	76%
Plan Socios Auxilio	$271	76%
Humana	$297 - $553	83%
Bella Vista	$325	91%
Mapfre	$325	91%
Cigna	$358	100%
Corvel Network	$358	100%
Mc	$388	109%
Ch	$453	127%
Bl	$650	182%
Privado	$650	182%
Aarp	$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 $1,788.
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 Hato Rey, Inc 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.