CMS Price Transparency Data
Digestive disorders treatment (inpatient stay)
Facility: Garfield Medical Center
Billing Code: 392 (MS-DRG)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 392
- Insurance Median: $8,440
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Garfield Medical Center is $8,440. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.49x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$8,440
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$5,675.87
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $5,675.87 (100%)
Insurance Median: $8,440 (149%)
Ins. Median: $8,440 (149% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $5,675.87 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.
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 |
|---|---|---|
| Health Net Foundation M Cal (Family Health Alliance) | $750 | 13% |
| UnitedHealthcare | $780 - $8,525 | 14% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $800 | 14% |
| Central Health Plan | $809 - $8,525 | 14% |
| One Health Plan | $850 | 15% |
| Interplan | $860 - $22,035 | 15% |
| Caloptima Direct | $892 | 16% |
| Alhambra Hospital | $900 | 16% |
| Corvel Corporation | $925 | 16% |
| Employee Health Systems Mg | $925 | 16% |
| Healthnet Medi Cal Cap | $1,014 | 18% |
| Blue Cross Blue Shield | $1,050 - $8,664 | 18% |
| Care 1St Mcl/Gar Cap Reciprocity | $1,050 | 18% |
| Care First Health Plan | $1,100 | 19% |
| Health Net | $1,187 - $13,022 | 21% |
| First Health Network | $1,224 - $8,664 | 22% |
| Molina Medical Group | $1,350 | 24% |
| Allied Physicians Risk Pool | $1,355 | 24% |
| Pipa Risk Pool Agreement | $1,480 | 26% |
| Physician Healthways Medical Corporation | $1,558 | 27% |
| Scan Health Plan Sr Hmo | $1,620 | 29% |
| La Care Health Plan | $1,700 - $8,525 | 30% |
| Care 1St Health Plan | $1,750 | 31% |
| Ahmc Healthcare Inc | $1,850 - $2,562 | 33% |
| Private Pay | $2,000 | 35% |
| Allied Physicians Risk Pool Agreement | $2,450 - $4,600 | 43% |
| Aetna | $2,574 - $8,525 | 45% |
| One Legacy | $3,000 | 53% |
| Blue Shield Of California | $3,885 - $8,664 | 68% |
| Blue Shield | $4,332 - $8,525 | 76% |
| Ahmc Health Epo | $4,797 | 85% |
| Veterans Administration | $6,065 | 107% |
| Cigna | $7,729 | 136% |
| Humana | $8,355 | 147% |
| Aids Health Foundation | $8,525 | 150% |
| Apa Aco Inc | $8,525 | 150% |
| Avanti | $8,525 - $10,397 | 150% |
| Beverly Hospital | $8,525 - $9,530 | 150% |
| Cms | $8,525 | 150% |
| Easy Choice Health Plan | $8,525 | 150% |
| Non-Contract Medi-Care | $8,525 | 150% |
| Pacific Alliance Medical Center Comm/Sr | $8,525 | 150% |
| Brand New Day | $8,664 - $10,830 | 153% |
| Emanate Health | $8,664 - $10,830 | 153% |
| La Care Covered Direct | $8,664 | 153% |
| Self-Pay | $8,664 | 153% |
| Ucla Impact Dept Of Uncology | $8,664 | 153% |
| Alignment Health Plan | $8,952 | 158% |
| Molina Healthcare | $8,952 | 158% |
| Molina Healthcare Of California | $8,952 - $10,830 | 158% |
| Inter Valley Health Plan | $9,097 | 160% |
| Cv-19 Hrsa Uninsured Testing And Tx | $9,213 | 162% |
| National Disaster Medical System | $9,530 | 168% |
| San Miguel Health Plan | $9,530 | 168% |
| Health Net Comm/Hmo | $9,886 - $15,534 | 174% |
| Health Net Inc | $9,886 | 174% |
| Chinatown Service Center Pace | $10,397 | 183% |
| Knox-Keene Act | $10,830 | 191% |
| Preferred Health Network | $14,116 | 249% |
| Athens Administrators | $14,859 | 262% |
| Multiplan | $14,859 | 262% |
| Other Non-Contracted Workers Compensation | $14,859 | 262% |
| Fmc Los Angeles Co Epo | $22,035 | 388% |