CMS Price Transparency Data
Physical therapy (therapeutic exercise)
Facility: Garfield Medical Center
Billing Code: 97110 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97110
- Insurance Median: $158
- Cash Discount Price: $309
- vs. Medicare Baseline: 5.44x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Garfield Medical Center is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $309. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.44x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$309
Average discount available for prompt cash payment at this facility.
Insurance Median
$158
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$29.06
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $29.06 (100%)
Cash / Self-Pay: $309 (1063%)
Insurance Median: $158 (544%)
Cash: $309 (1063% of Medicare)
Ins. Median: $158 (544% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $29.06 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 544% of the Medicare baseline (a markup of 444%). 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.
Input your details and click calculate to compare out-of-pocket costs.
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 | $9 - $48 | 31% |
| Blue Cross Blue Shield | $9 - $325 | 31% |
| Ahmc Healthcare Inc | $11 - $123 | 38% |
| Beverly Hospital | $11 - $35 | 38% |
| Brand New Day | $11 - $40 | 38% |
| Care 1St Mcl/Gar Cap Reciprocity | $11 | 38% |
| Community Health Plan | $11 | 38% |
| Emanate Health | $11 - $40 | 38% |
| Health Net | $11 - $222 | 38% |
| Healthy Way La | $11 | 38% |
| La Care Health Plan | $11 - $225 | 38% |
| Other Non-Contracting Medi-Cal | $11 | 38% |
| Aids Health Foundation | $13 - $32 | 45% |
| Avanti | $13 - $38 | 45% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $13 | 45% |
| Hollywood Presbyterian Medpoint Mcal | $13 | 45% |
| State Of California Medi-Cal | $13 | 45% |
| Physician Healthways Medical Corporation | $14 | 48% |
| Caloptima Direct | $18 | 62% |
| Veterans Administration | $22 | 76% |
| Associated Hispanic Phys Of So Cal | $24 - $82 | 83% |
| Care First Health Plan | $24 - $41 | 83% |
| UnitedHealthcare | $24 - $245 | 83% |
| Aetna | $31 - $298 | 107% |
| Apa Aco Inc | $32 | 110% |
| Blue Shield | $32 - $438 | 110% |
| Blue Shield Of California | $32 - $393 | 110% |
| Central Health Plan | $32 - $164 | 110% |
| Cms | $32 | 110% |
| Cv-19 Hrsa Uninsured Testing And Tx | $32 | 110% |
| Easy Choice Health Plan | $32 | 110% |
| First Health Network | $32 - $286 | 110% |
| Humana | $32 | 110% |
| Interplan | $32 - $307 | 110% |
| La Care Covered Direct | $32 | 110% |
| Non-Contract Medi-Care | $32 | 110% |
| Pacific Alliance Medical Center Comm/Sr | $32 | 110% |
| Preferred Health Network | $32 | 110% |
| Scan Health Plan Sr Hmo | $32 | 110% |
| Self-Pay | $32 | 110% |
| Ucla Impact Dept Of Uncology | $32 | 110% |
| Alignment Health Plan | $33 | 114% |
| Athens Administrators | $33 | 114% |
| Molina Healthcare | $33 | 114% |
| Molina Healthcare Of California | $33 - $40 | 114% |
| Multiplan | $33 - $348 | 114% |
| Other Non-Contracted Workers Compensation | $33 | 114% |
| Inter Valley Health Plan | $34 | 117% |
| National Disaster Medical System | $35 | 120% |
| San Miguel Health Plan | $35 | 120% |
| Chinatown Service Center Pace | $38 | 131% |
| Ahmc Health Epo | $40 | 138% |
| Knox-Keene Act | $40 | 138% |
| Advantage Care Ipa | $45 - $409 | 155% |
| Physicians Healthways Medi-Cal | $45 - $409 | 155% |
| Physicians Healthways Medical Corporation | $45 - $409 | 155% |
| Employee Health Systems Mg | $49 - $82 | 169% |
| Health Net Comm/Hmo | $51 - $225 | 175% |
| Health Net Inc | $52 | 179% |
| Access Ipa Ancillary | $60 | 206% |
| Family Health Alliance | $60 | 206% |
| Pacific Independent Physician Association | $60 | 206% |
| Private Pay | $60 | 206% |
| Allied Physicians Risk Pool | $85 - $143 | 292% |
| Allied Physicians Risk Pool Agreement | $85 - $143 | 292% |
| Healthnet Medi Cal Cap | $85 - $143 | 292% |
| Pipa Risk Pool Agreement | $85 - $143 | 292% |
| Molina Medical Group | $95 - $160 | 327% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $98 - $164 | 337% |
| Health Net Foundation M Cal (Family Health Alliance) | $98 - $164 | 337% |
| Phys Assoc Of San Gab Valley | $98 - $164 | 337% |
| Allied Physicians Med Grp | $122 - $204 | 420% |
| Alhambra Hospital | $146 - $245 | 502% |
| Care 1St Health Plan | $146 - $245 | 502% |
| One Health Plan | $171 - $286 | 588% |
| Pacificare Ppo | $181 | 623% |
| Fmc Los Angeles Co Epo | $183 - $307 | 630% |
| Corvel Corporation | $195 - $327 | 671% |
| Americas Health Plan | $207 - $348 | 712% |
| Health Payors Organization | $220 - $368 | 757% |
| Cigna | $244 - $409 | 840% |
| East La Reg Ctr | $244 - $409 | 840% |
| Non Contract Commercial | $244 - $409 | 840% |
| One Legacy | $244 - $409 | 840% |
| Pacificare Of California Inc | $246 | 847% |