CMS Price Transparency Data

MRI, lower back (no contrast)

Facility: Caribbean Medical Center

Billing Code: 72148 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72148
Insurance Median: $71
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a MRI, lower back (no contrast) at Caribbean Medical Center is $71. 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 $243.77, this hospital’s rate is 0.29x 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

$71

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%)

Insurance Median: $71 (29%)

Ins. Median: $71 (29% 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
Humana	$68	28%
Medicare (plans)	$68	28%
Mmm	$68	28%
Veteran Administration	$68	28%
Tricare	$69	28%
Champva	$71	29%
First Medical Ases	$71	29%
Mmm Multi Health Ases	$71	29%
Triples S Reforma	$71	29%
Health First	$73	30%
UnitedHealthcare	$73	30%
Well Care	$73	30%
Tsa	$76	31%
Mcs Classicare	$228	94%
Asociacion De Maestros Pr	$250	103%
Mcs Privado	$260	107%
Auxilio Mutuo	$325	133%
Auxilio Mutuo Plus	$325	133%
Imc Privado	$325	133%

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: 72148.

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 72148.
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.