CMS Price Transparency Data
Physical therapy (neuromuscular re-education)
Facility: Garfield Medical Center
Billing Code: 97112 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97112
- Insurance Median: $147
- Cash Discount Price: $271
- vs. Medicare Baseline: 4.49x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Garfield Medical Center is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $271. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 4.49x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$271
Average discount available for prompt cash payment at this facility.
Insurance Median
$147
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$32.73
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $32.73 (100%)
Cash / Self-Pay: $271 (828%)
Insurance Median: $147 (449%)
Cash: $271 (828% of Medicare)
Ins. Median: $147 (449% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $32.73 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 449% of the Medicare baseline (a markup of 349%). 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 |
|---|---|---|
| Allied Physicians | $10 - $54 | 31% |
| Blue Cross Blue Shield | $10 - $325 | 31% |
| Ahmc Healthcare Inc | $12 - $128 | 37% |
| Beverly Hospital | $12 - $40 | 37% |
| Brand New Day | $12 - $45 | 37% |
| Care 1St Mcl/Gar Cap Reciprocity | $12 | 37% |
| Community Health Plan | $12 | 37% |
| Emanate Health | $12 - $45 | 37% |
| Health Net | $12 - $231 | 37% |
| Healthy Way La | $12 | 37% |
| La Care Health Plan | $12 - $234 | 37% |
| Other Non-Contracting Medi-Cal | $12 | 37% |
| Aids Health Foundation | $14 - $36 | 43% |
| Avanti | $14 - $43 | 43% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $14 | 43% |
| Hollywood Presbyterian Medpoint Mcal | $14 | 43% |
| State Of California Medi-Cal | $14 | 43% |
| Physician Healthways Medical Corporation | $16 | 49% |
| Caloptima Direct | $21 | 64% |
| Associated Hispanic Phys Of So Cal | $24 - $85 | 73% |
| Care First Health Plan | $24 - $42 | 73% |
| UnitedHealthcare | $24 - $255 | 73% |
| Veterans Administration | $25 | 76% |
| Interplan | $32 - $319 | 98% |
| Preferred Health Network | $32 | 98% |
| Aetna | $33 - $309 | 101% |
| Athens Administrators | $33 | 101% |
| Multiplan | $33 - $361 | 101% |
| Other Non-Contracted Workers Compensation | $33 | 101% |
| Apa Aco Inc | $36 | 110% |
| Blue Shield | $36 - $438 | 110% |
| Blue Shield Of California | $36 - $393 | 110% |
| Central Health Plan | $36 - $170 | 110% |
| Cms | $36 | 110% |
| Cv-19 Hrsa Uninsured Testing And Tx | $36 | 110% |
| Easy Choice Health Plan | $36 | 110% |
| First Health Network | $36 - $298 | 110% |
| Humana | $36 | 110% |
| La Care Covered Direct | $36 | 110% |
| Non-Contract Medi-Care | $36 | 110% |
| Pacific Alliance Medical Center Comm/Sr | $36 | 110% |
| Scan Health Plan Sr Hmo | $36 | 110% |
| Self-Pay | $36 | 110% |
| Ucla Impact Dept Of Uncology | $36 | 110% |
| Alignment Health Plan | $37 | 113% |
| Molina Healthcare | $37 | 113% |
| Molina Healthcare Of California | $37 - $45 | 113% |
| Inter Valley Health Plan | $38 | 116% |
| National Disaster Medical System | $40 | 122% |
| San Miguel Health Plan | $40 | 122% |
| Chinatown Service Center Pace | $43 | 131% |
| Advantage Care Ipa | $45 - $425 | 137% |
| Ahmc Health Epo | $45 | 137% |
| Knox-Keene Act | $45 | 137% |
| Physicians Healthways Medi-Cal | $45 - $425 | 137% |
| Physicians Healthways Medical Corporation | $45 - $425 | 137% |
| Employee Health Systems Mg | $49 - $85 | 150% |
| Health Net Comm/Hmo | $57 - $234 | 174% |
| Health Net Inc | $59 | 180% |
| Access Ipa Ancillary | $60 | 183% |
| Family Health Alliance | $60 | 183% |
| Pacific Independent Physician Association | $60 | 183% |
| Private Pay | $60 | 183% |
| Allied Physicians Risk Pool | $86 - $149 | 263% |
| Allied Physicians Risk Pool Agreement | $86 - $149 | 263% |
| Healthnet Medi Cal Cap | $86 - $149 | 263% |
| Pipa Risk Pool Agreement | $86 - $149 | 263% |
| Molina Medical Group | $96 - $166 | 293% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $98 - $170 | 299% |
| Health Net Foundation M Cal (Family Health Alliance) | $98 - $170 | 299% |
| Phys Assoc Of San Gab Valley | $98 - $170 | 299% |
| Allied Physicians Med Grp | $122 - $212 | 373% |
| Alhambra Hospital | $147 - $255 | 449% |
| Care 1St Health Plan | $147 - $255 | 449% |
| One Health Plan | $172 - $298 | 526% |
| Pacificare Ppo | $181 | 553% |
| Fmc Los Angeles Co Epo | $184 - $319 | 562% |
| Corvel Corporation | $196 - $340 | 599% |
| Americas Health Plan | $208 - $361 | 636% |
| Health Payors Organization | $220 - $382 | 672% |
| Cigna | $245 - $425 | 749% |
| East La Reg Ctr | $245 - $425 | 749% |
| Non Contract Commercial | $245 - $425 | 749% |
| One Legacy | $245 - $425 | 749% |
| Pacificare Of California Inc | $246 | 752% |