Puerto Rico · 74018

X-Ray Of Abdomen, 1 View in Puerto Rico

Puerto Rico Medicare Avg
$11.42
30% above national avg
National Medicare Avg
$8.78
All states combined
Billed Charge (PR)
$28.08
What providers submit
Est. Commercial (PR)
$36.31
National avg: $26.15
Est. Cash / Self-Pay (PR)
$19.88
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

926
Services in PR
169
Providers
N/A
Min Payment
N/A
Max Payment

Puerto Rico Pricing in Context

In Puerto Rico, CPT code 74018 (X-Ray Of Abdomen, 1 View) carries an average Medicare payment of $11.42 — 30% above the national benchmark of $8.78. 169 providers across the state submitted claims for this procedure in 2023, performing 926 total services. Individual payments in PR ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Puerto Rico is $28.08, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Puerto Rico sits above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for X-Ray procedures, the estimated commercial insurance price in Puerto Rico lands near $36.31, with self-pay cash prices typically around $19.88. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does X-Ray Of Abdomen, 1 View cost in Puerto Rico?

The average Medicare payment for X-Ray Of Abdomen, 1 View in Puerto Rico is $11.42, which is 30% above the national average of $8.78. Providers in PR typically bill $28.08 for this procedure.

What does X-Ray Of Abdomen, 1 View cost with insurance in Puerto Rico?

With commercial insurance in Puerto Rico, X-Ray Of Abdomen, 1 View costs an estimated $36.31. Without insurance, the estimated cash price is $19.88. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform X-Ray Of Abdomen, 1 View in Puerto Rico?

169 providers in Puerto Rico billed Medicare for X-Ray Of Abdomen, 1 View in 2023, performing 926 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is X-Ray Of Abdomen, 1 View cheaper in Puerto Rico than the national average?

No — X-Ray Of Abdomen, 1 View costs 30% above the national average in Puerto Rico. The state average Medicare payment is $11.42 compared to $8.78 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial