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Hospital Profile Acute Care Hospital Proprietary 154 Beds · urban Updated: 2025-04-10

Hospital Pavia Santurce

Street Profesor Augusto Rodriguez #1462, San Juan, PR 00910 · 58 Priced Procedures

CMS Overall Rating 1 / 5 Stars
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
0.95×vs. Fair Market Price
Position vs. 1.00× Fair Price5% Below Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are 5% below the fair benchmark (0.95×) after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).61/100 · Caution
61/100Self-Pay Cash Beats Insurance 1% of the Time
File Completeness61Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic80Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment70Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing79Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount6Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.Regional Benchmark Tier
CMS Star Rating1/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score53/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.

1-Star CMS clinical quality rating paired with 0.95× fair market pricing.

Behavioral Pricing FingerprintMedian-Gamed · High Captive Markup

Loss-Leader / Captive Ancillary Cross-Subsidizer

Hospital Pavia Santurce prices routine shoppable procedures near 0.7× Medicare (p50 0.78×) while skewing captive emergency, lab, and upper-quartile codes to 1.5× Medicare (p75 1.40×, +79% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.

#5 of 17 in PR · 23rd State Percentile#995 of 3,385 in U.S. · 29th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Elective shoppable care is priced 5% below peer Fair BaseRate (0.95×)
  • Self-pay cash beats commercial insurance on 1% of shoppable procedures (25/100 Cash Honesty)
  • 1-Star CMS clinical rating with 72% patient recommendation (53/100 safety score)
  • 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 (0.95× 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 (1.0×) & laboratory (1.3×) services average 2.14× higher multiples than routine shoppable care (0.7×)
  • Upper-quartile procedures (Q75 1.40×) jump +79% above the median procedure ratio (Q50 0.78×)
  • Unnegotiated chargemaster list prices average 5.6× Medicare (17¢ true HCRIS cost per $1 gross)
Front-Door ShoppableElective / Imaging
0.7× Medicare

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

Back-Door Captive & ER2.14× Divergence
1.5× Medicare

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

Quantile Tail Spread+79% Upper Tail
Q25 0.57× · Q50 0.78× · Q75 1.40×

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
0.7× MedicareGood
Outpatient Surgery & ORBack-Door Captive
0.9× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
0.6× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
1.0× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
1.3× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.1× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
1% Cash Edge · 25/100Watchout
CMS Clinical Safety & Star ValueIntegrity & Outcomes
1 CMS · 53/100Elevated

Procedure Prices at Hospital Pavia Santurce

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 58 published procedures.

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Audit a Bill & 501(r) Cap ↓
Procedure & Billing Code This Hospital vs. Fair
MRI, brain (with and without contrast)
CPT Code: 70553
 $325 0.6×
Gallbladder removal (laparoscopic)
CPT Code: 47562
 $350 0.1×
Upper endoscopy with biopsy
CPT Code: 43239
 $316 0.3×
Colonoscopy with biopsy
CPT Code: 45380
 $316 0.3×
MRI, brain (no contrast)
CPT Code: 70551
 $263 0.8×
MRI, knee or other leg joint
CPT Code: 73721
 $240 0.7×
MRI, lower back (no contrast)
CPT Code: 72148
 $218 0.6×
CT scan, abdomen and pelvis (with contrast)
CPT Code: 74177
 $191 0.4×
Colonoscopy (diagnostic)
CPT Code: 45378
 $200 0.2×
CT scan, pelvis
CPT Code: 72192
 $127 0.8×
CT scan, lower back (lumbar spine)
CPT Code: 72131
 $129 0.8×
CT scan, neck (cervical spine)
CPT Code: 72125
 $129 0.8×
CT scan, head (with and without contrast)
CPT Code: 70470
 $148 0.6×
X-ray, ankle
CPT Code: 73610
 $99 1.1×
CT scan, chest (no contrast)
CPT Code: 71250
 $114 0.7×
CT scan, abdomen and pelvis (no contrast)
CPT Code: 74176
 $116 0.4×
X-ray, shoulder
CPT Code: 73030
 $88 1.0×
X-ray, foot
CPT Code: 73630
 $88 1.0×
X-ray, chest (two views)
CPT Code: 71046
 $88 0.9×
X-ray, neck (cervical spine)
CPT Code: 72040
 $88 0.9×
X-ray, hip
CPT Code: 73502
 $88 0.9×
CT scan, sinuses
CPT Code: 70486
 $113 0.7×
X-ray, chest (single view)
CPT Code: 71045
 $85 0.9×
CT scan, head (no contrast)
CPT Code: 70450
 $105 0.7×
CT scan, head (with contrast)
CPT Code: 70460
 $122 0.5×
Showing top 25 high-impact procedures of 58 total
Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

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

CMS CCN: 400019
CPT 70553
Fair BaseRate™ $511
Medicare Rate $356
Self-Pay Cash $1,788
Insurer Median $325
Pre-filled with Hospital Pavia Santurce’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
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: $1,788

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Hospital Pavia Santurce's published 45 CFR § 180 self-pay cash rate is $1,788 (vs. $325 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$1,277 Above Fair BaseRate

Negotiate Toward $511 Fair BaseRate ($356 Medicare)

Your bill ($1,788) is $1,277 above the denoised Fair BaseRate ($511) and 5.0× the $356 Medicare rate.

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 Santurce 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

CMS Overall1/5 Stars (1/5)
Safety Composite53/100
30-Day Mortality vs U.S.same
Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)
Central-Line Bloodstream Infectionworse

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Hospital Pavia Santurce. Prior administrative notices do not necessarily reflect current compliance status.

  • 2023-05-30·administrative_or_closure

    Met Requirements

    Recorded

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

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

Price Index: 0.92× regional baseline
Quality: 26/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Aetna
-57.0%
Median Household Income$26,981U.S. Census ACS
Local Uninsured Share9.0%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 61/100 · Caution CMS CCN 400019

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 400019) ↗ CMS HCRIS Cost Reports ↗
Published MRF FileCMS_45_CFR_180_FILING.json
Publication / Vintage2025-04-10
Validated Rate Rows1,411 (CMS v3.0.0)
File Integrity DigestVerified · CCN 400019

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