CMS Price Transparency Data

CT scan, pelvis

Facility: Garfield Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $216
  • Cash Discount Price: $6,378
  • vs. Medicare Baseline: 2.02x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Garfield Medical Center is $216. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,378. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.02x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$6,378

Average discount available for prompt cash payment at this facility.

Insurance Median
$216

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%)
Cash / Self-Pay: $6,378 (5971%)
Insurance Median: $216 (202%)
Cash: $6,378 (5971% of Medicare)
Ins. Median: $216 (202% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 202% of the Medicare baseline (a markup of 102%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $40 - $3,189 37%
Advantage Care Ipa $79 - $6,378 74%
Physicians Healthways Medical Corporation $79 - $6,378 74%
Veterans Administration $94 88%
Beverly Hospital $128 - $148 120%
Brand New Day $128 - $168 120%
Care 1St Mcl/Gar Cap Reciprocity $128 120%
Community Health Plan $128 120%
Emanate Health $128 - $168 120%
Health Net $128 - $5,358 120%
Healthy Way La $128 120%
La Care Health Plan $128 - $3,508 120%
Other Non-Contracting Medi-Cal $128 120%
Physicians Healthways Medi-Cal $128 - $6,378 120%
Aetna $132 - $2,640 124%
Aids Health Foundation $132 - $334 124%
Apa Aco Inc $132 124%
Avanti $132 - $334 124%
Blue Shield $132 - $2,528 124%
Central Health Plan $132 - $1,200 124%
Cms $132 124%
Easy Choice Health Plan $132 124%
Humana $132 124%
Non-Contract Medi-Care $132 124%
Pacific Alliance Medical Center Comm/Sr $132 124%
UnitedHealthcare $132 - $2,900 124%
Blue Shield Of California $134 - $3,189 125%
Cv-19 Hrsa Uninsured Testing And Tx $134 125%
First Health Network $134 - $3,300 125%
La Care Covered Direct $134 125%
Scan Health Plan Sr Hmo $134 125%
Self-Pay $134 125%
Ucla Impact Dept Of Uncology $134 125%
Alignment Health Plan $139 130%
Molina Healthcare $139 130%
Molina Healthcare Of California $139 - $168 130%
Inter Valley Health Plan $141 132%
National Disaster Medical System $148 139%
San Miguel Health Plan $148 139%
Chinatown Service Center Pace $161 151%
Ahmc Health Epo $168 157%
Knox-Keene Act $168 157%
Preferred Health Network $170 159%
Interplan $173 - $4,784 162%
Pacificare Of California Inc $178 167%
Pacificare Ppo $178 167%
Athens Administrators $179 168%
Multiplan $179 - $5,421 168%
Other Non-Contracted Workers Compensation $179 168%
Health Net Comm/Hmo $214 - $3,508 200%
Health Net Inc $218 204%
Hollywood Presbyterian Advanced Med Mgmt Mcal $334 313%
Hollywood Presbyterian Medpoint Mcal $334 313%
State Of California Medi-Cal $334 313%
Ahmc Healthcare Inc $345 - $1,500 323%
Molina Medical Group $478 448%
Caloptima Direct $491 460%
Associated Hispanic Phys Of So Cal $638 - $1,276 597%
Cigna $1,301 1218%
Access Ipa Ancillary $2,551 2388%
Health Net Foundation Comm/Sr (Family Health Alliance) $2,551 2388%
Health Net Foundation M Cal (Family Health Alliance) $2,551 2388%
One Health Plan $2,551 2388%
Pacific Independent Physician Association $2,551 2388%
Phys Assoc Of San Gab Valley $2,551 2388%
Alhambra Hospital $3,827 3583%
Corvel Corporation $4,465 4180%
Fmc Los Angeles Co Epo $4,784 4479%
Americas Health Plan $5,421 5075%
Health Payors Organization $5,740 5374%
East La Reg Ctr $6,378 5971%
Non Contract Commercial $6,378 5971%
One Legacy $6,378 5971%
Private Pay $6,378 5971%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 N Garfield Ave, Monterey Park, CA 91754
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals