CMS Price Transparency Data

CT scan, head (with contrast)

Facility: Caribbean Medical Center

Billing Code: 70460 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70460
Insurance Median: $101
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.56x Medicare

The contracted insurance negotiated median rate for a CT scan, head (with contrast) at Caribbean Medical Center is $101. 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 0.56x 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

$101

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: $101 (56%)

Ins. Median: $101 (56% 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	$45 - $129	25%
Humana	$51 - $98	28%
Medicare (plans)	$51 - $109	28%
Mmm	$51 - $91	28%
Veteran Administration	$51 - $74	28%
Tricare	$52 - $109	29%
First Medical Ases	$54 - $101	30%
Mmm Multi Health Ases	$54 - $101	30%
Triples S Reforma	$54 - $116	30%
Champva	$55 - $109	31%
Health First	$55	31%
UnitedHealthcare	$55	31%
Well Care	$55 - $109	31%
Tsa	$58 - $109	32%
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%
Cfse	$167	93%
Panamerican Life Insurance	$175	98%
Acaa	$178	99%
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: 70460.

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 70460.
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.