CMS Price Transparency Data
Culture, blood
Facility: Garfield Medical Center
Billing Code: 87040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 87040
- Insurance Median: $178
- Cash Discount Price: $606
- vs. Medicare Baseline: 17.25x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Garfield Medical Center is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $606. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 17.25x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$606
Average discount available for prompt cash payment at this facility.
Insurance Median
$178
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$10.32
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $10.32 (100%)
Cash / Self-Pay: $606 (5872%)
Insurance Median: $178 (1725%)
Cash: $606 (5872% of Medicare)
Ins. Median: $178 (1725% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $10.32 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 1725% of the Medicare baseline (a markup of 1625%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 |
|---|---|---|
| Veterans Administration | $7 | 68% |
| Ahmc Healthcare Inc | $9 - $186 | 87% |
| Allied Physicians | $9 - $15 | 87% |
| Beverly Hospital | $9 - $11 | 87% |
| Blue Cross Blue Shield | $9 - $310 | 87% |
| Brand New Day | $9 - $13 | 87% |
| Care 1St Mcl/Gar Cap Reciprocity | $9 | 87% |
| Community Health Plan | $9 | 87% |
| Emanate Health | $9 - $13 | 87% |
| Health Net | $9 - $521 | 87% |
| Healthy Way La | $9 | 87% |
| La Care Health Plan | $9 - $341 | 87% |
| Other Non-Contracting Medi-Cal | $9 | 87% |
| Physicians Healthways Medi-Cal | $9 - $620 | 87% |
| Advantage Care Ipa | $10 - $620 | 97% |
| Aetna | $10 - $451 | 97% |
| Aids Health Foundation | $10 | 97% |
| Apa Aco Inc | $10 | 97% |
| Avanti | $10 - $12 | 97% |
| Blue Shield | $10 - $145 | 97% |
| Blue Shield Of California | $10 - $310 | 97% |
| Central Health Plan | $10 - $248 | 97% |
| Cms | $10 | 97% |
| Cv-19 Hrsa Uninsured Testing And Tx | $10 | 97% |
| Easy Choice Health Plan | $10 | 97% |
| First Health Network | $10 - $434 | 97% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $10 | 97% |
| Hollywood Presbyterian Medpoint Mcal | $10 | 97% |
| Humana | $10 | 97% |
| La Care Covered Direct | $10 | 97% |
| Non-Contract Medi-Care | $10 | 97% |
| Pacific Alliance Medical Center Comm/Sr | $10 | 97% |
| Physicians Healthways Medical Corporation | $10 - $620 | 97% |
| Scan Health Plan Sr Hmo | $10 | 97% |
| Self-Pay | $10 | 97% |
| State Of California Medi-Cal | $10 | 97% |
| Ucla Impact Dept Of Uncology | $10 | 97% |
| UnitedHealthcare | $10 - $372 | 97% |
| Alignment Health Plan | $11 | 107% |
| Cigna | $11 | 107% |
| Inter Valley Health Plan | $11 | 107% |
| Molina Healthcare | $11 | 107% |
| Molina Healthcare Of California | $11 - $13 | 107% |
| National Disaster Medical System | $11 | 107% |
| San Miguel Health Plan | $11 | 107% |
| Athens Administrators | $12 | 116% |
| Chinatown Service Center Pace | $12 | 116% |
| Interplan | $12 - $465 | 116% |
| Multiplan | $12 - $527 | 116% |
| Other Non-Contracted Workers Compensation | $12 | 116% |
| Physician Healthways Medical Corporation | $12 | 116% |
| Preferred Health Network | $12 | 116% |
| Ahmc Health Epo | $13 | 126% |
| Knox-Keene Act | $13 | 126% |
| Caloptima Direct | $15 | 145% |
| Health Net Comm/Hmo | $16 - $341 | 155% |
| Health Net Inc | $17 | 165% |
| Pacificare Of California Inc | $21 | 203% |
| Pacificare Ppo | $21 | 203% |
| Pacific Independent Physician Association | $47 - $99 | 455% |
| Access Ipa Ancillary | $59 - $186 | 572% |
| Associated Hispanic Phys Of So Cal | $59 - $124 | 572% |
| Care First Health Plan | $59 - $62 | 572% |
| Employee Health Systems Mg | $118 - $124 | 1143% |
| Family Health Alliance | $178 - $186 | 1725% |
| Allied Physicians Risk Pool | $207 - $217 | 2006% |
| Allied Physicians Risk Pool Agreement | $207 - $217 | 2006% |
| Healthnet Medi Cal Cap | $207 - $217 | 2006% |
| Pipa Risk Pool Agreement | $207 - $217 | 2006% |
| Molina Medical Group | $231 - $242 | 2238% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $237 - $248 | 2297% |
| Health Net Foundation M Cal (Family Health Alliance) | $237 - $248 | 2297% |
| Phys Assoc Of San Gab Valley | $237 - $248 | 2297% |
| Allied Physicians Med Grp | $296 - $310 | 2868% |
| Alhambra Hospital | $355 - $372 | 3440% |
| Care 1St Health Plan | $355 - $372 | 3440% |
| One Health Plan | $414 - $434 | 4012% |
| Fmc Los Angeles Co Epo | $444 - $465 | 4302% |
| Corvel Corporation | $474 - $496 | 4593% |
| Americas Health Plan | $503 - $527 | 4874% |
| Health Payors Organization | $533 - $558 | 5165% |
| East La Reg Ctr | $592 - $620 | 5736% |
| Non Contract Commercial | $592 - $620 | 5736% |
| One Legacy | $592 - $620 | 5736% |
| Private Pay | $592 - $620 | 5736% |