CMS Price Transparency Data
Ultrasound, pelvis
Facility: Garfield Medical Center
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $179
- Cash Discount Price: $1,954
- vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Garfield Medical Center is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,954. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.68x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$1,954
Average discount available for prompt cash payment at this facility.
Insurance Median
$179
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$106.81
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $1,954 (1829%)
Insurance Median: $179 (168%)
Cash: $1,954 (1829% of Medicare)
Ins. Median: $179 (168% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $106.81 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $21 - $977 | 20% |
| Advantage Care Ipa | $68 - $1,954 | 64% |
| Ahmc Healthcare Inc | $68 - $586 | 64% |
| Allied Physicians | $68 - $202 | 64% |
| Beverly Hospital | $68 - $148 | 64% |
| Brand New Day | $68 - $168 | 64% |
| Care 1St Mcl/Gar Cap Reciprocity | $68 | 64% |
| Community Health Plan | $68 | 64% |
| Emanate Health | $68 - $168 | 64% |
| Health Net | $68 - $1,641 | 64% |
| Healthy Way La | $68 | 64% |
| La Care Health Plan | $68 - $1,075 | 64% |
| Other Non-Contracting Medi-Cal | $68 | 64% |
| Physicians Healthways Medi-Cal | $68 - $1,954 | 64% |
| Physicians Healthways Medical Corporation | $74 - $1,954 | 69% |
| Veterans Administration | $94 | 88% |
| Aids Health Foundation | $97 - $132 | 91% |
| Avanti | $97 - $161 | 91% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $97 | 91% |
| Hollywood Presbyterian Medpoint Mcal | $97 | 91% |
| State Of California Medi-Cal | $97 | 91% |
| Physician Healthways Medical Corporation | $112 | 105% |
| Aetna | $132 - $1,423 | 124% |
| Apa Aco Inc | $132 | 124% |
| Blue Shield | $132 - $655 | 124% |
| Central Health Plan | $132 - $782 | 124% |
| Cms | $132 | 124% |
| Easy Choice Health Plan | $132 | 124% |
| Humana | $132 | 124% |
| Non-Contract Medi-Care | $132 | 124% |
| Pacific Alliance Medical Center Comm/Sr | $132 | 124% |
| UnitedHealthcare | $132 - $1,172 | 124% |
| Blue Shield Of California | $134 - $977 | 125% |
| Cv-19 Hrsa Uninsured Testing And Tx | $134 | 125% |
| First Health Network | $134 - $1,368 | 125% |
| La Care Covered Direct | $134 | 125% |
| Scan Health Plan Sr Hmo | $134 | 125% |
| Self-Pay | $134 | 125% |
| Ucla Impact Dept Of Uncology | $134 | 125% |
| Alignment Health Plan | $139 | 130% |
| Molina Healthcare | $139 | 130% |
| Molina Healthcare Of California | $139 - $168 | 130% |
| Inter Valley Health Plan | $141 | 132% |
| Caloptima Direct | $143 | 134% |
| National Disaster Medical System | $148 | 139% |
| San Miguel Health Plan | $148 | 139% |
| Pacific Independent Physician Association | $156 - $313 | 146% |
| Chinatown Service Center Pace | $161 | 151% |
| Ahmc Health Epo | $168 | 157% |
| Knox-Keene Act | $168 | 157% |
| Preferred Health Network | $170 | 159% |
| Interplan | $173 - $1,466 | 162% |
| Pacificare Of California Inc | $178 | 167% |
| Pacificare Ppo | $178 | 167% |
| Athens Administrators | $179 | 168% |
| Multiplan | $179 - $1,661 | 168% |
| Other Non-Contracted Workers Compensation | $179 | 168% |
| Access Ipa Ancillary | $195 - $500 | 183% |
| Associated Hispanic Phys Of So Cal | $195 - $391 | 183% |
| Care First Health Plan | $195 | 183% |
| Health Net Comm/Hmo | $214 - $1,075 | 200% |
| Health Net Inc | $218 | 204% |
| Cigna | $241 | 226% |
| Employee Health Systems Mg | $391 | 366% |
| Family Health Alliance | $500 | 468% |
| Allied Physicians Risk Pool | $684 | 640% |
| Allied Physicians Risk Pool Agreement | $684 | 640% |
| Healthnet Medi Cal Cap | $684 | 640% |
| Pipa Risk Pool Agreement | $684 | 640% |
| Molina Medical Group | $762 | 713% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $782 | 732% |
| Health Net Foundation M Cal (Family Health Alliance) | $782 | 732% |
| Phys Assoc Of San Gab Valley | $782 | 732% |
| Allied Physicians Med Grp | $977 | 915% |
| Alhambra Hospital | $1,172 | 1097% |
| Care 1St Health Plan | $1,172 | 1097% |
| One Health Plan | $1,368 | 1281% |
| Fmc Los Angeles Co Epo | $1,466 | 1373% |
| Corvel Corporation | $1,563 | 1463% |
| Americas Health Plan | $1,661 | 1555% |
| Health Payors Organization | $1,759 | 1647% |
| East La Reg Ctr | $1,954 | 1829% |
| Non Contract Commercial | $1,954 | 1829% |
| One Legacy | $1,954 | 1829% |
| Private Pay | $1,954 | 1829% |