Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Puerto Rico
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
Puerto Rico Pricing in Context
In Puerto Rico, CPT code 96417 (Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less) carries an average Medicare payment of $46.93 — 8% below the national benchmark of $50.77. 48 providers across the state submitted claims for this procedure in 2023, performing 742 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 $64.30, 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 below the national Medicare average, commercial rates in the state may also run lower than the US median.
Using RAND 2024 commercial-to-Medicare ratios for Medicine procedures, the estimated commercial insurance price in Puerto Rico lands near $132.50, with self-pay cash prices typically around $62.05. 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 Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cost in Puerto Rico?
The average Medicare payment for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Puerto Rico is $46.93, which is 8% below the national average of $50.77. Providers in PR typically bill $64.30 for this procedure.
What does Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cost with insurance in Puerto Rico?
With commercial insurance in Puerto Rico, Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs an estimated $132.50. Without insurance, the estimated cash price is $62.05. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.
How many providers perform Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in Puerto Rico?
48 providers in Puerto Rico billed Medicare for Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less in 2023, performing 742 total services. Medicare payments ranged from N/A to N/A depending on the provider.
Is Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less cheaper in Puerto Rico than the national average?
Yes — Administration Of Additional New Drug Or Substance Into Vein, 1 Hour Or Less costs 8% below the national average in Puerto Rico. The state average Medicare payment is $46.93 compared to $50.77 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.
Related Guides
Related Data Sources
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology — how this data is sourced, computed, and verified.