CMS Price Transparency Data
Ultrasound, thyroid and neck
Facility: Garfield Medical Center
Billing Code: 76536 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76536
- Insurance Median: $530
- Cash Discount Price: $1,600
- vs. Medicare Baseline: 4.96x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Garfield Medical Center is $530. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,600. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.96x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$1,600
Average discount available for prompt cash payment at this facility.
Insurance Median
$530
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: $1,600 (1498%)
Insurance Median: $530 (496%)
Cash: $1,600 (1498% of Medicare)
Ins. Median: $530 (496% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 496% of the Medicare baseline (a markup of 396%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $19 - $884 | 18% |
| Advantage Care Ipa | $60 - $1,768 | 56% |
| Ahmc Healthcare Inc | $60 - $530 | 56% |
| Allied Physicians | $60 - $202 | 56% |
| Beverly Hospital | $60 - $148 | 56% |
| Brand New Day | $60 - $168 | 56% |
| Care 1St Mcl/Gar Cap Reciprocity | $60 | 56% |
| Community Health Plan | $60 | 56% |
| Emanate Health | $60 - $168 | 56% |
| Health Net | $60 - $1,485 | 56% |
| Healthy Way La | $60 | 56% |
| La Care Health Plan | $60 - $972 | 56% |
| Other Non-Contracting Medi-Cal | $60 | 56% |
| Physicians Healthways Medi-Cal | $60 - $1,768 | 56% |
| Physicians Healthways Medical Corporation | $77 - $1,768 | 72% |
| Aids Health Foundation | $86 - $132 | 81% |
| Avanti | $86 - $161 | 81% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $86 | 81% |
| Hollywood Presbyterian Medpoint Mcal | $86 | 81% |
| State Of California Medi-Cal | $86 | 81% |
| Veterans Administration | $94 | 88% |
| Physician Healthways Medical Corporation | $99 | 93% |
| Pacific Independent Physician Association | $101 - $283 | 95% |
| Access Ipa Ancillary | $126 - $500 | 118% |
| Associated Hispanic Phys Of So Cal | $126 - $354 | 118% |
| Caloptima Direct | $126 | 118% |
| Care First Health Plan | $126 - $177 | 118% |
| UnitedHealthcare | $126 - $1,061 | 118% |
| Aetna | $132 - $1,287 | 124% |
| Apa Aco Inc | $132 | 124% |
| Blue Shield | $132 - $611 | 124% |
| Central Health Plan | $132 - $707 | 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% |
| Blue Shield Of California | $134 - $884 | 125% |
| Cv-19 Hrsa Uninsured Testing And Tx | $134 | 125% |
| First Health Network | $134 - $1,238 | 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% |
| National Disaster Medical System | $148 | 139% |
| San Miguel Health Plan | $148 | 139% |
| Chinatown Service Center Pace | $161 | 151% |
| Ahmc Health Epo | $168 | 157% |
| Knox-Keene Act | $168 | 157% |
| Preferred Health Network | $170 | 159% |
| Interplan | $173 - $1,326 | 162% |
| Pacificare Of California Inc | $178 | 167% |
| Pacificare Ppo | $178 | 167% |
| Athens Administrators | $179 | 168% |
| Multiplan | $179 - $1,503 | 168% |
| Other Non-Contracted Workers Compensation | $179 | 168% |
| Health Net Comm/Hmo | $214 - $972 | 200% |
| Health Net Inc | $218 | 204% |
| Cigna | $241 | 226% |
| Employee Health Systems Mg | $252 - $354 | 236% |
| Family Health Alliance | $378 - $500 | 354% |
| Allied Physicians Risk Pool | $441 - $619 | 413% |
| Allied Physicians Risk Pool Agreement | $441 - $619 | 413% |
| Healthnet Medi Cal Cap | $441 - $619 | 413% |
| Pipa Risk Pool Agreement | $441 - $619 | 413% |
| Molina Medical Group | $491 - $690 | 460% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $504 - $707 | 472% |
| Health Net Foundation M Cal (Family Health Alliance) | $504 - $707 | 472% |
| Phys Assoc Of San Gab Valley | $504 - $707 | 472% |
| Allied Physicians Med Grp | $630 - $884 | 590% |
| Alhambra Hospital | $756 - $1,061 | 708% |
| Care 1St Health Plan | $756 - $1,061 | 708% |
| One Health Plan | $882 - $1,238 | 826% |
| Fmc Los Angeles Co Epo | $945 - $1,326 | 885% |
| Corvel Corporation | $1,008 - $1,414 | 944% |
| Americas Health Plan | $1,071 - $1,503 | 1003% |
| Health Payors Organization | $1,134 - $1,591 | 1062% |
| East La Reg Ctr | $1,260 - $1,768 | 1180% |
| Non Contract Commercial | $1,260 - $1,768 | 1180% |
| One Legacy | $1,260 - $1,768 | 1180% |
| Private Pay | $1,260 - $1,768 | 1180% |