CMS Price Transparency Data

X-ray, pelvis

Facility: Caribbean Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $12
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.11x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Caribbean Medical Center is $12. 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 $106.81, this hospital’s rate is 0.11x 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
$12

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Insurance Median: $12 (11%)
Ins. Median: $12 (11% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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.

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
Acaa $5 - $10 5%
Asociacion De Maestros Pr $7 - $14 7%
Menonita Ases $7 - $25 7%
Champva $8 - $24 7%
First Medical Ases $8 - $20 7%
Hoffa $8 7%
Humana $8 - $19 7%
Imc Privado $8 7%
Medicare (plans) $8 - $25 7%
Mmm $8 - $25 7%
Mmm Multi Health Ases $8 - $20 7%
Tricare $8 - $24 7%
Triples S Reforma $8 - $11 7%
Veteran Administration $8 - $13 7%
Health First $9 8%
Tsa $9 - $24 8%
UnitedHealthcare $9 8%
Well Care $9 - $24 8%
Panamerican Life Insurance $10 9%
Union Carpinteros $11 10%
Mapfre $12 11%
Mcs Classicare $12 11%
Mcs Privado $12 11%
Auxilio Mutuo $14 - $27 13%
Auxilio Mutuo Plus $14 - $27 13%
Menonita Privado $14 - $27 13%
Triple S Privado $14 13%
Cfse $33 31%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 151 Ave Osvaldo Molina, Fajardo, PR 00738
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals