CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Garfield Medical Center
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $98
- Cash Discount Price: $235
- vs. Medicare Baseline: 3.54x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Garfield Medical Center is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $235. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 3.54x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$235
Average discount available for prompt cash payment at this facility.
Insurance Median
$98
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$27.72
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $27.72 (100%)
Cash / Self-Pay: $235 (848%)
Insurance Median: $98 (354%)
Cash: $235 (848% of Medicare)
Ins. Median: $98 (354% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $27.72 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 354% of the Medicare baseline (a markup of 254%). 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 |
|---|---|---|
| Associated Hispanic Phys Of So Cal | $19 - $53 | 69% |
| Care First Health Plan | $19 - $26 | 69% |
| UnitedHealthcare | $19 - $206 | 69% |
| Veterans Administration | $21 | 76% |
| Ahmc Healthcare Inc | $22 - $80 | 79% |
| Allied Physicians | $22 - $46 | 79% |
| Beverly Hospital | $22 - $34 | 79% |
| Blue Cross Blue Shield | $22 - $325 | 79% |
| Brand New Day | $22 - $38 | 79% |
| Care 1St Mcl/Gar Cap Reciprocity | $22 | 79% |
| Community Health Plan | $22 | 79% |
| Emanate Health | $22 - $38 | 79% |
| Health Net | $22 - $180 | 79% |
| Healthy Way La | $22 | 79% |
| La Care Health Plan | $22 - $146 | 79% |
| Other Non-Contracting Medi-Cal | $22 | 79% |
| Aetna | $30 - $193 | 108% |
| Aids Health Foundation | $30 - $32 | 108% |
| Apa Aco Inc | $30 | 108% |
| Avanti | $30 - $37 | 108% |
| Blue Shield | $30 - $438 | 108% |
| Central Health Plan | $30 - $106 | 108% |
| Cms | $30 | 108% |
| Easy Choice Health Plan | $30 | 108% |
| Humana | $30 | 108% |
| Non-Contract Medi-Care | $30 | 108% |
| Pacific Alliance Medical Center Comm/Sr | $30 | 108% |
| Blue Shield Of California | $31 - $393 | 112% |
| Cv-19 Hrsa Uninsured Testing And Tx | $31 | 112% |
| First Health Network | $31 - $186 | 112% |
| La Care Covered Direct | $31 | 112% |
| Scan Health Plan Sr Hmo | $31 | 112% |
| Self-Pay | $31 | 112% |
| Ucla Impact Dept Of Uncology | $31 | 112% |
| Alignment Health Plan | $32 | 115% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $32 | 115% |
| Hollywood Presbyterian Medpoint Mcal | $32 | 115% |
| Inter Valley Health Plan | $32 | 115% |
| Molina Healthcare | $32 | 115% |
| Molina Healthcare Of California | $32 - $38 | 115% |
| State Of California Medi-Cal | $32 | 115% |
| National Disaster Medical System | $34 | 123% |
| San Miguel Health Plan | $34 | 123% |
| Chinatown Service Center Pace | $37 | 133% |
| Physician Healthways Medical Corporation | $37 | 133% |
| Ahmc Health Epo | $38 | 137% |
| Employee Health Systems Mg | $38 - $53 | 137% |
| Knox-Keene Act | $38 | 137% |
| Preferred Health Network | $42 | 152% |
| Interplan | $43 - $199 | 155% |
| Athens Administrators | $44 | 159% |
| Multiplan | $44 - $225 | 159% |
| Other Non-Contracted Workers Compensation | $44 | 159% |
| Advantage Care Ipa | $45 - $265 | 162% |
| Physicians Healthways Medi-Cal | $45 - $265 | 162% |
| Physicians Healthways Medical Corporation | $45 - $265 | 162% |
| Caloptima Direct | $47 | 170% |
| Health Net Comm/Hmo | $49 - $146 | 177% |
| Health Net Inc | $50 | 180% |
| Access Ipa Ancillary | $60 | 216% |
| Family Health Alliance | $60 | 216% |
| Pacific Independent Physician Association | $60 | 216% |
| Private Pay | $60 | 216% |
| Allied Physicians Risk Pool | $66 - $93 | 238% |
| Allied Physicians Risk Pool Agreement | $66 - $93 | 238% |
| Healthnet Medi Cal Cap | $66 - $93 | 238% |
| Pipa Risk Pool Agreement | $66 - $93 | 238% |
| Molina Medical Group | $73 - $103 | 263% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $75 - $106 | 271% |
| Health Net Foundation M Cal (Family Health Alliance) | $75 - $106 | 271% |
| Phys Assoc Of San Gab Valley | $75 - $106 | 271% |
| Allied Physicians Med Grp | $94 - $132 | 339% |
| Alhambra Hospital | $113 - $159 | 408% |
| Care 1St Health Plan | $113 - $159 | 408% |
| One Health Plan | $132 - $186 | 476% |
| Fmc Los Angeles Co Epo | $141 - $199 | 509% |
| Corvel Corporation | $150 - $212 | 541% |
| Americas Health Plan | $160 - $225 | 577% |
| Health Payors Organization | $169 - $238 | 610% |
| Pacificare Ppo | $181 | 653% |
| Cigna | $188 - $265 | 678% |
| East La Reg Ctr | $188 - $265 | 678% |
| Non Contract Commercial | $188 - $265 | 678% |
| One Legacy | $188 - $265 | 678% |
| Pacificare Of California Inc | $246 | 887% |