CMS Price Transparency Data

CT scan, head (with and without contrast)

Facility: Caribbean Medical Center

Billing Code: 70470 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70470
Insurance Median: $122
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.68x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with and without contrast) at Caribbean Medical Center is $122. 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 $179.2, this hospital’s rate is 0.68x 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

$122

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$179.2

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $179.2 (100%)

Insurance Median: $122 (68%)

Ins. Median: $122 (68% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $179.2 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	$50 - $151	28%
Humana	$58 - $117	32%
Medicare (plans)	$58 - $131	32%
Mmm	$58 - $111	32%
Veteran Administration	$58 - $90	32%
Tricare	$59 - $131	33%
Champva	$61 - $131	34%
First Medical Ases	$61 - $122	34%
Mmm Multi Health Ases	$61 - $122	34%
Triples S Reforma	$61 - $116	34%
Health First	$62	35%
UnitedHealthcare	$62	35%
Well Care	$62 - $131	35%
Tsa	$65 - $131	36%
Hoffa	$120	67%
Mcs Classicare	$122	68%
Asociacion De Maestros Pr	$130 - $260	73%
Mapfre	$130 - $162	73%
Imc Privado	$138	77%
Triple S Privado	$138	77%
Mcs Privado	$140	78%
Menonita Privado	$150 - $300	84%
Union Carpinteros	$150	84%
Acaa	$178	99%
Cfse	$196	109%
Panamerican Life Insurance	$200	112%
Auxilio Mutuo	$275	153%
Auxilio Mutuo Plus	$275	153%

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: 70470.

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 70470.
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.