CMS Price Transparency Data
Speech therapy (language evaluation)
Facility: Garfield Medical Center
Billing Code: 92507 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 92507
- Insurance Median: $263
- Cash Discount Price: $676
- vs. Medicare Baseline: 3.45x Medicare
The contracted insurance negotiated median rate for a Speech therapy (language evaluation) at Garfield Medical Center is $263. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $676. Compared to the federal Medicare reimbursement reference rate of $76.15, this hospital’s rate is 3.45x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$676
Average discount available for prompt cash payment at this facility.
Insurance Median
$263
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$76.15
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $76.15 (100%)
Cash / Self-Pay: $676 (888%)
Insurance Median: $263 (345%)
Cash: $676 (888% of Medicare)
Ins. Median: $263 (345% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $76.15 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 345% of the Medicare baseline (a markup of 245%). 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 |
|---|---|---|
| Allied Physicians | $24 - $126 | 32% |
| Associated Hispanic Phys Of So Cal | $24 - $377 | 32% |
| Blue Cross Blue Shield | $24 - $942 | 32% |
| Care First Health Plan | $24 - $188 | 32% |
| UnitedHealthcare | $24 - $1,131 | 32% |
| Ahmc Healthcare Inc | $30 - $566 | 39% |
| Beverly Hospital | $30 - $92 | 39% |
| Brand New Day | $30 - $105 | 39% |
| Care 1St Mcl/Gar Cap Reciprocity | $30 | 39% |
| Community Health Plan | $30 | 39% |
| Emanate Health | $30 - $105 | 39% |
| Health Net | $30 - $1,024 | 39% |
| Healthy Way La | $30 | 39% |
| La Care Health Plan | $30 - $1,037 | 39% |
| Other Non-Contracting Medi-Cal | $30 | 39% |
| Aids Health Foundation | $34 - $82 | 45% |
| Avanti | $34 - $100 | 45% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $34 | 45% |
| Hollywood Presbyterian Medpoint Mcal | $34 | 45% |
| State Of California Medi-Cal | $34 | 45% |
| Physician Healthways Medical Corporation | $39 | 51% |
| Employee Health Systems Mg | $49 - $377 | 64% |
| Caloptima Direct | $50 | 66% |
| Private Pay | $50 | 66% |
| Veterans Administration | $59 | 77% |
| Access Ipa Ancillary | $60 | 79% |
| Family Health Alliance | $60 | 79% |
| Pacific Independent Physician Association | $60 | 79% |
| Preferred Health Network | $62 | 81% |
| Interplan | $63 - $1,414 | 83% |
| Athens Administrators | $65 | 85% |
| Multiplan | $65 - $1,602 | 85% |
| Other Non-Contracted Workers Compensation | $65 | 85% |
| Advantage Care Ipa | $70 - $1,885 | 92% |
| Physicians Healthways Medi-Cal | $70 - $1,885 | 92% |
| Physicians Healthways Medical Corporation | $70 - $1,885 | 92% |
| Aetna | $82 - $1,372 | 108% |
| Apa Aco Inc | $82 | 108% |
| Blue Shield | $82 - $438 | 108% |
| Central Health Plan | $82 - $754 | 108% |
| Cms | $82 | 108% |
| Easy Choice Health Plan | $82 | 108% |
| Humana | $82 | 108% |
| Non-Contract Medi-Care | $82 | 108% |
| Pacific Alliance Medical Center Comm/Sr | $82 | 108% |
| Blue Shield Of California | $84 - $942 | 110% |
| Cv-19 Hrsa Uninsured Testing And Tx | $84 | 110% |
| First Health Network | $84 - $1,320 | 110% |
| La Care Covered Direct | $84 | 110% |
| Scan Health Plan Sr Hmo | $84 | 110% |
| Self-Pay | $84 | 110% |
| Ucla Impact Dept Of Uncology | $84 | 110% |
| Allied Physicians Risk Pool | $86 - $660 | 113% |
| Allied Physicians Risk Pool Agreement | $86 - $660 | 113% |
| Healthnet Medi Cal Cap | $86 - $660 | 113% |
| Pipa Risk Pool Agreement | $86 - $660 | 113% |
| Alignment Health Plan | $87 | 114% |
| Molina Healthcare | $87 | 114% |
| Molina Healthcare Of California | $87 - $105 | 114% |
| Inter Valley Health Plan | $88 | 116% |
| National Disaster Medical System | $92 | 121% |
| San Miguel Health Plan | $92 | 121% |
| Molina Medical Group | $96 - $735 | 126% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $98 - $754 | 129% |
| Health Net Foundation M Cal (Family Health Alliance) | $98 - $754 | 129% |
| Phys Assoc Of San Gab Valley | $98 - $754 | 129% |
| Chinatown Service Center Pace | $100 | 131% |
| Ahmc Health Epo | $105 | 138% |
| Knox-Keene Act | $105 | 138% |
| Allied Physicians Med Grp | $122 - $942 | 160% |
| Health Net Comm/Hmo | $133 - $1,037 | 175% |
| Health Net Inc | $136 | 179% |
| Alhambra Hospital | $147 - $1,131 | 193% |
| Care 1St Health Plan | $147 - $1,131 | 193% |
| One Health Plan | $172 - $1,320 | 226% |
| Pacificare Ppo | $181 | 238% |
| Fmc Los Angeles Co Epo | $184 - $1,414 | 242% |
| Corvel Corporation | $196 - $1,508 | 257% |
| Americas Health Plan | $208 - $1,602 | 273% |
| Health Payors Organization | $220 - $1,696 | 289% |
| Cigna | $245 - $453 | 322% |
| East La Reg Ctr | $245 - $1,885 | 322% |
| Non Contract Commercial | $245 - $1,885 | 322% |
| One Legacy | $245 - $1,885 | 322% |
| Pacificare Of California Inc | $246 | 323% |