CMS Price Transparency Data
Physical therapy (functional capacity test)
Facility: Garfield Medical Center
Billing Code: 97750 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97750
- Insurance Median: $40
- Cash Discount Price: $80
- vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Garfield Medical Center is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.19x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$80
Average discount available for prompt cash payment at this facility.
Insurance Median
$40
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$33.73
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $33.73 (100%)
Cash / Self-Pay: $80 (237%)
Insurance Median: $40 (119%)
Cash: $80 (237% of Medicare)
Ins. Median: $40 (119% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $33.73 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 |
|---|---|---|
| Associated Hispanic Phys Of So Cal | $8 - $16 | 24% |
| Care First Health Plan | $8 | 24% |
| UnitedHealthcare | $8 - $206 | 24% |
| Ahmc Healthcare Inc | $12 - $24 | 36% |
| Allied Physicians | $12 - $56 | 36% |
| Beverly Hospital | $12 - $41 | 36% |
| Blue Cross Blue Shield | $12 - $325 | 36% |
| Brand New Day | $12 - $47 | 36% |
| Care 1St Mcl/Gar Cap Reciprocity | $12 | 36% |
| Community Health Plan | $12 | 36% |
| Emanate Health | $12 - $47 | 36% |
| Health Net | $12 - $180 | 36% |
| Healthy Way La | $12 | 36% |
| La Care Health Plan | $12 - $44 | 36% |
| Other Non-Contracting Medi-Cal | $12 | 36% |
| Aids Health Foundation | $16 - $37 | 47% |
| Avanti | $16 - $45 | 47% |
| Employee Health Systems Mg | $16 | 47% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $16 | 47% |
| Hollywood Presbyterian Medpoint Mcal | $16 | 47% |
| State Of California Medi-Cal | $16 | 47% |
| Physician Healthways Medical Corporation | $19 | 56% |
| Caloptima Direct | $24 | 71% |
| Veterans Administration | $26 | 77% |
| Allied Physicians Risk Pool | $28 | 83% |
| Allied Physicians Risk Pool Agreement | $28 | 83% |
| Healthnet Medi Cal Cap | $28 | 83% |
| Pipa Risk Pool Agreement | $28 | 83% |
| Molina Medical Group | $31 | 92% |
| Central Health Plan | $32 - $37 | 95% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $32 | 95% |
| Health Net Foundation M Cal (Family Health Alliance) | $32 | 95% |
| Phys Assoc Of San Gab Valley | $32 | 95% |
| Aetna | $34 - $58 | 101% |
| Apa Aco Inc | $37 | 110% |
| Blue Shield | $37 - $438 | 110% |
| Cms | $37 | 110% |
| Easy Choice Health Plan | $37 | 110% |
| Humana | $37 | 110% |
| Non-Contract Medi-Care | $37 | 110% |
| Pacific Alliance Medical Center Comm/Sr | $37 | 110% |
| Blue Shield Of California | $38 - $393 | 113% |
| Cv-19 Hrsa Uninsured Testing And Tx | $38 | 113% |
| First Health Network | $38 - $56 | 113% |
| La Care Covered Direct | $38 | 113% |
| Scan Health Plan Sr Hmo | $38 | 113% |
| Self-Pay | $38 | 113% |
| Ucla Impact Dept Of Uncology | $38 | 113% |
| Alignment Health Plan | $39 | 116% |
| Inter Valley Health Plan | $39 | 116% |
| Molina Healthcare | $39 | 116% |
| Molina Healthcare Of California | $39 - $47 | 116% |
| Allied Physicians Med Grp | $40 | 119% |
| National Disaster Medical System | $41 | 122% |
| San Miguel Health Plan | $41 | 122% |
| Preferred Health Network | $43 | 127% |
| Health Net Comm/Hmo | $44 - $60 | 130% |
| Interplan | $44 - $60 | 130% |
| Chinatown Service Center Pace | $45 | 133% |
| Athens Administrators | $46 | 136% |
| Multiplan | $46 - $68 | 136% |
| Other Non-Contracted Workers Compensation | $46 | 136% |
| Ahmc Health Epo | $47 | 139% |
| Knox-Keene Act | $47 | 139% |
| Alhambra Hospital | $48 | 142% |
| Care 1St Health Plan | $48 | 142% |
| Advantage Care Ipa | $50 - $80 | 148% |
| Physicians Healthways Medi-Cal | $50 - $80 | 148% |
| Physicians Healthways Medical Corporation | $50 - $80 | 148% |
| One Health Plan | $56 | 166% |
| Access Ipa Ancillary | $60 | 178% |
| Family Health Alliance | $60 | 178% |
| Fmc Los Angeles Co Epo | $60 | 178% |
| Pacific Independent Physician Association | $60 | 178% |
| Private Pay | $60 | 178% |
| Health Net Inc | $61 | 181% |
| Corvel Corporation | $64 | 190% |
| Americas Health Plan | $68 | 202% |
| Health Payors Organization | $72 | 213% |
| Cigna | $80 | 237% |
| East La Reg Ctr | $80 | 237% |
| Non Contract Commercial | $80 | 237% |
| One Legacy | $80 | 237% |
| Pacificare Ppo | $181 | 537% |
| Pacificare Of California Inc | $246 | 729% |