CMS Price Transparency Data
Ultrasound, leg veins (duplex)
Facility: Garfield Medical Center
Billing Code: 93970 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 93970
- Insurance Median: $941
- Cash Discount Price: $4,318
- vs. Medicare Baseline: 3.86x Medicare
The contracted insurance negotiated median rate for a Ultrasound, leg veins (duplex) at Garfield Medical Center is $941. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,318. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.86x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$4,318
Average discount available for prompt cash payment at this facility.
Insurance Median
$941
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$243.77
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $4,318 (1771%)
Insurance Median: $941 (386%)
Cash: $4,318 (1771% of Medicare)
Ins. Median: $941 (386% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $243.77 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 386% of the Medicare baseline (a markup of 286%). 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 |
|---|---|---|
| Pacific Independent Physician Association | $103 - $724 | 42% |
| Access Ipa Ancillary | $129 - $500 | 53% |
| Associated Hispanic Phys Of So Cal | $129 - $905 | 53% |
| Care First Health Plan | $129 - $453 | 53% |
| UnitedHealthcare | $129 - $3,743 | 53% |
| Allied Physicians | $135 - $460 | 55% |
| Blue Cross Blue Shield | $135 - $2,263 | 55% |
| Ahmc Healthcare Inc | $168 - $1,358 | 69% |
| Beverly Hospital | $168 - $338 | 69% |
| Brand New Day | $168 - $384 | 69% |
| Care 1St Mcl/Gar Cap Reciprocity | $168 | 69% |
| Community Health Plan | $168 | 69% |
| Emanate Health | $168 - $384 | 69% |
| Health Net | $168 - $3,802 | 69% |
| Healthy Way La | $168 | 69% |
| La Care Health Plan | $168 - $2,489 | 69% |
| Other Non-Contracting Medi-Cal | $168 | 69% |
| Physicians Healthways Medi-Cal | $168 - $4,526 | 69% |
| Aids Health Foundation | $193 - $302 | 79% |
| Avanti | $193 - $368 | 79% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $193 | 79% |
| Hollywood Presbyterian Medpoint Mcal | $193 | 79% |
| State Of California Medi-Cal | $193 | 79% |
| Veterans Administration | $215 | 88% |
| Physician Healthways Medical Corporation | $222 | 91% |
| Caloptima Direct | $284 | 117% |
| Aetna | $302 - $2,640 | 124% |
| Apa Aco Inc | $302 | 124% |
| Blue Shield | $302 - $1,664 | 124% |
| Central Health Plan | $302 - $1,200 | 124% |
| Cms | $302 | 124% |
| Easy Choice Health Plan | $302 | 124% |
| Humana | $302 | 124% |
| Non-Contract Medi-Care | $302 | 124% |
| Pacific Alliance Medical Center Comm/Sr | $302 | 124% |
| Physicians Healthways Medical Corporation | $302 - $4,526 | 124% |
| Advantage Care Ipa | $307 - $4,526 | 126% |
| Blue Shield Of California | $307 - $2,263 | 126% |
| Cv-19 Hrsa Uninsured Testing And Tx | $307 | 126% |
| First Health Network | $307 - $3,168 | 126% |
| La Care Covered Direct | $307 | 126% |
| Scan Health Plan Sr Hmo | $307 | 126% |
| Self-Pay | $307 | 126% |
| Ucla Impact Dept Of Uncology | $307 | 126% |
| Alignment Health Plan | $317 | 130% |
| Molina Healthcare | $317 | 130% |
| Molina Healthcare Of California | $317 - $384 | 130% |
| Inter Valley Health Plan | $322 | 132% |
| National Disaster Medical System | $338 | 139% |
| San Miguel Health Plan | $338 | 139% |
| Athens Administrators | $350 | 144% |
| Interplan | $350 - $3,394 | 144% |
| Multiplan | $350 - $3,847 | 144% |
| Other Non-Contracted Workers Compensation | $350 | 144% |
| Preferred Health Network | $350 | 144% |
| Chinatown Service Center Pace | $368 | 151% |
| Ahmc Health Epo | $384 | 158% |
| Knox-Keene Act | $384 | 158% |
| Family Health Alliance | $388 - $500 | 159% |
| Allied Physicians Risk Pool | $453 - $1,584 | 186% |
| Allied Physicians Risk Pool Agreement | $453 - $1,584 | 186% |
| Healthnet Medi Cal Cap | $453 - $1,584 | 186% |
| Pipa Risk Pool Agreement | $453 - $1,584 | 186% |
| Health Net Comm/Hmo | $488 - $2,489 | 200% |
| Health Net Inc | $498 | 204% |
| Molina Medical Group | $504 - $1,350 | 207% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $517 - $1,810 | 212% |
| Health Net Foundation M Cal (Family Health Alliance) | $517 - $1,810 | 212% |
| Phys Assoc Of San Gab Valley | $517 - $1,810 | 212% |
| Cigna | $547 | 224% |
| Allied Physicians Med Grp | $646 - $1,100 | 265% |
| Alhambra Hospital | $776 - $2,716 | 318% |
| Care 1St Health Plan | $776 - $2,716 | 318% |
| Employee Health Systems Mg | $776 - $2,000 | 318% |
| One Health Plan | $905 - $3,168 | 371% |
| Pacificare Ppo | $914 - $3,200 | 375% |
| Fmc Los Angeles Co Epo | $970 - $3,394 | 398% |
| Corvel Corporation | $1,034 - $3,621 | 424% |
| Americas Health Plan | $1,099 - $3,847 | 451% |
| Health Payors Organization | $1,164 - $4,073 | 477% |
| Pacificare Of California Inc | $1,279 - $4,476 | 525% |
| East La Reg Ctr | $1,293 - $4,526 | 530% |
| Non Contract Commercial | $1,293 - $4,526 | 530% |
| One Legacy | $1,293 - $4,526 | 530% |
| Private Pay | $1,293 - $4,526 | 530% |