CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Caribbean Medical Center

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 74177
Insurance Median: $190
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.53x Medicare

The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Caribbean Medical Center is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 0.53x the Medicare baseline. Located in 151 Ave Osvaldo Molina, Fajardo, PR.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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%)

Insurance Median: $190 (53%)

Ins. Median: $190 (53% 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
Menonita Ases	$72 - $246	20%
Humana	$84 - $224	24%
Medicare (plans)	$84 - $225	24%
Mmm	$84 - $190	24%
Tricare	$84 - $225	24%
Veteran Administration	$84 - $155	24%
Champva	$87 - $225	24%
First Medical Ases	$87 - $235	24%
Mmm Multi Health Ases	$87 - $235	24%
Triples S Reforma	$87 - $218	24%
Health First	$89	25%
UnitedHealthcare	$89	25%
Well Care	$89 - $225	25%
Tsa	$94 - $225	26%
Hoffa	$120	34%
Imc Privado	$138	39%
Mapfre	$150 - $200	42%
Menonita Privado	$150 - $300	42%
Union Carpinteros	$150	42%
Mcs Classicare	$168	47%
Mcs Privado	$190	53%
Asociacion De Maestros Pr	$200 - $450	56%
Panamerican Life Insurance	$225	63%
Triple S Privado	$225	63%
Acaa	$275	77%
Cfse	$319	89%
Auxilio Mutuo	$450	126%
Auxilio Mutuo Plus	$450	126%

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 $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 74177.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Caribbean Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 74177.
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.