How many shoppable procedure prices are published for Hospital Pavia Arecibo?

Hospital Pavia Arecibo in Arecibo, PR currently has 55 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Hospital Pavia Arecibo's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Hospital Pavia Arecibo's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Acute Care Hospital Proprietary 185 Beds · urban Updated: 2025-04-10

Hospital Pavia Arecibo

Carretera 129 Km.1 Avenida San Luis, Arecibo, PR 00612 · 55 Priced Procedures

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

1.03×vs. Fair Market Price

Typical commercial prices here are +3% above the fair benchmark (1.03×) even after accounting for local nurse/doctor wages and patient complexity.

59/100 · Caution

59/100Self-Pay Cash Beats Insurance 6% of the Time

File Completeness66

Price Logic74

Peer Alignment70

Clean Billing70

Real Cash Discount6

Regional Benchmark Tier

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Hospital Pavia Arecibo prices routine shoppable procedures near 0.8× Medicare (p50 1.02×) while skewing captive emergency, lab, and upper-quartile codes to 1.4× Medicare (p75 1.30×, +27% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#7 of 17 in PR · 35th State Percentile#1,440 of 3,385 in U.S. · 42nd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.59× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 6% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (40/100 safety score) with 72% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.03× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (1.2×) & laboratory (1.4×) services average 1.75× higher multiples than routine shoppable care (0.8×)
Upper-quartile procedures (Q75 1.30×) jump +27% above the median procedure ratio (Q50 1.02×)
Consolidated metro market (HHI 5,026) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

0.8× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.75× Divergence

1.4× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+27% Upper Tail

Q25 0.59× · Q50 1.02× · Q75 1.30×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

0.8× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.0× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.9× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.2× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.4× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.1× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

6% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 40/100Watchout

Procedure Prices at Hospital Pavia Arecibo

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 55 published procedures.

Sort:

Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Gallbladder removal (laparoscopic) CPT Code: `47562`	$350	$350	$6,109	0.1×
MRI, brain (with and without contrast) CPT Code: `70553`	$532	$302	$511	0.6×
MRI, lower back (no contrast) CPT Code: `72148`	$532	$249	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$532	$249	$343	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$532	$247	$369	0.7×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$255	$163	$448	0.4×
CT scan, sinuses CPT Code: `70486`	$188	$123	$166	0.7×
CT scan, head (no contrast) CPT Code: `70450`	$188	$117	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$188	$119	$163	0.7×
CT scan, chest (no contrast) CPT Code: `71250`	$188	$120	$167	0.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$188	$121	$169	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$188	$120	$168	0.7×
CT scan, head (with contrast) CPT Code: `70460`	$188	$130	$242	0.5×
CT scan, head (with and without contrast) CPT Code: `70470`	$188	$132	$258	0.5×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$225	$144	$303	0.5×
Blood test, vitamin D CPT Code: `82306`	$156	$44	$31	1.4×
X-ray, shoulder CPT Code: `73030`	$49	$49	$92	0.5×
Blood test, PSA (prostate screen) CPT Code: `84153`	$80	$23	$19	1.2×
X-ray, chest (two views) CPT Code: `71046`	$45	$45	$93	0.5×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$16	$6	$3	2.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$64	$7	$5	1.4×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$180	$19	$14	1.4×
X-ray, foot CPT Code: `73630`	$43	$43	$92	0.5×
X-ray, ankle CPT Code: `73610`	$43	$43	$93	0.5×
Blood test, thyroid (TSH) CPT Code: `84443`	$13	$13	$18	0.7×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$30	$19	$35	0.5×
X-ray, chest (single view) CPT Code: `71045`	$38	$38	$92	0.4×
X-ray, neck (cervical spine) CPT Code: `72040`	$38	$38	$93	0.4×
X-ray, hand CPT Code: `73130`	$38	$38	$93	0.4×
Ultrasound, abdomen (limited) CPT Code: `76705`	$45	$44	$126	0.3×
Ultrasound, pelvis CPT Code: `76856`	$45	$45	$130	0.3×
Ultrasound, abdomen (complete) CPT Code: `76700`	$45	$45	$134	0.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$45	$44	$132	0.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$48	$6	$4	1.5×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$15	$14	$10	1.4×
Blood test, sodium CPT Code: `84295`	$29	$7	$5	1.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$40	$15	$11	1.4×
Blood test, clotting time (PTT) CPT Code: `85730`	$52	$8	$6	1.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$51	$18	$14	1.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$88	$5	$4	1.3×
Blood test, liver function panel CPT Code: `80076`	$257	$11	$9	1.2×
Blood test, potassium CPT Code: `84132`	$29	$6	$5	1.2×
Blood test, lipase CPT Code: `83690`	$94	$8	$7	1.1×
X-ray, hip CPT Code: `73502`	$29	$29	$93	0.3×
X-ray, pelvis CPT Code: `72170`	$33	$33	$110	0.3×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$225	$36	$148	0.2×
Blood test, calcium CPT Code: `82310`	$26	$6	$5	1.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$14	$6	$5	1.2×
Blood test, hemoglobin CPT Code: `85018`	$24	$3	$3	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	$200	$28	$123	0.2×
X-ray, lower back CPT Code: `72110`	$65	$21	$112	0.2×
Blood test, basic metabolic panel CPT Code: `80048`	$24	$12	$9	unverified
Blood test, amylase CPT Code: `82150`	$35	$9	$7	unverified
Blood test, vitamin B12 CPT Code: `82607`	$64	$20	$16	unverified
Blood test, magnesium CPT Code: `83735`	$40	$9	$7	unverified

Showing top 25 high-impact procedures of 55 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Hospital Pavia Arecibo (Zero PHI Required)

CMS CCN: 400087

CPT 47562

Select Procedure to Audit:

Fair BaseRate™ $6,109

Medicare Rate $6,176

Self-Pay Cash $350

Insurer Median $350

1. Amount on Your Bill or Quote ($) Pre-filled with Hospital Pavia Arecibo’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $350

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Hospital Pavia Arecibo's published 45 CFR § 180 self-pay cash rate is $350 (vs. $350 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target Target: $6,109 Fair BaseRate

Negotiate Toward $6,109 Fair BaseRate ($6,176 Medicare)

Your entered amount is at or below the modeled Fair BaseRate benchmark ($6,109).

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Public IRS & CMS ownership records classify Hospital Pavia Arecibo as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

Safety Composite40/100

30-Day Mortality vs U.S.worse

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionworse

Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Hospital Pavia Arecibo.

Price Index: 0.89× regional baseline

Quality: 33/100 CMS composite

Median Household Income$23,175U.S. Census ACS

Local Uninsured Share6.7%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 59/100 · Caution CMS CCN 400087

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 400087) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2025-04-10

Validated Rate Rows1,238 (CMS v3.0.0)

File Integrity DigestVerified · CCN 400087

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy