CMS Price Transparency Data
X-ray, neck (cervical spine)
Facility: Garfield Medical Center
Billing Code: 72040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72040
- Insurance Median: $182
- Cash Discount Price: $687
- vs. Medicare Baseline: 2.05x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Garfield Medical Center is $182. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $687. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.05x the Medicare baseline. Located in 525 N Garfield Ave, Monterey Park, CA.
Cash / Self-Pay
$687
Average discount available for prompt cash payment at this facility.
Insurance Median
$182
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$88.91
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $687 (773%)
Insurance Median: $182 (205%)
Cash: $687 (773% of Medicare)
Ins. Median: $182 (205% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $88.91 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 205% of the Medicare baseline (a markup of 105%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $8 - $428 | 9% |
| Ucla Impact Dept Of Uncology | $9 | 10% |
| Advantage Care Ipa | $20 - $857 | 22% |
| Physicians Healthways Medical Corporation | $20 - $857 | 22% |
| Ahmc Healthcare Inc | $26 - $257 | 29% |
| Allied Physicians | $26 - $168 | 29% |
| Beverly Hospital | $26 - $123 | 29% |
| Brand New Day | $26 - $140 | 29% |
| Care 1St Mcl/Gar Cap Reciprocity | $26 | 29% |
| Community Health Plan | $26 | 29% |
| Emanate Health | $26 - $140 | 29% |
| Health Net | $26 - $720 | 29% |
| Healthy Way La | $26 | 29% |
| La Care Health Plan | $26 - $471 | 29% |
| Other Non-Contracting Medi-Cal | $26 | 29% |
| Physicians Healthways Medi-Cal | $26 - $857 | 29% |
| Aids Health Foundation | $37 - $110 | 42% |
| Avanti | $37 - $134 | 42% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $37 | 42% |
| Hollywood Presbyterian Medpoint Mcal | $37 | 42% |
| State Of California Medi-Cal | $37 | 42% |
| Aetna | $41 - $624 | 46% |
| Pacific Independent Physician Association | $41 - $137 | 46% |
| Physician Healthways Medical Corporation | $43 | 48% |
| Access Ipa Ancillary | $52 - $257 | 58% |
| Associated Hispanic Phys Of So Cal | $52 - $171 | 58% |
| Care First Health Plan | $52 - $86 | 58% |
| UnitedHealthcare | $52 - $514 | 58% |
| Caloptima Direct | $55 | 62% |
| Veterans Administration | $78 | 88% |
| Employee Health Systems Mg | $103 - $171 | 116% |
| Apa Aco Inc | $110 | 124% |
| Blue Shield | $110 - $259 | 124% |
| Central Health Plan | $110 - $343 | 124% |
| Cms | $110 | 124% |
| Easy Choice Health Plan | $110 | 124% |
| Humana | $110 | 124% |
| Non-Contract Medi-Care | $110 | 124% |
| Pacific Alliance Medical Center Comm/Sr | $110 | 124% |
| Blue Shield Of California | $112 - $428 | 126% |
| Cv-19 Hrsa Uninsured Testing And Tx | $112 | 126% |
| First Health Network | $112 - $600 | 126% |
| La Care Covered Direct | $112 | 126% |
| Scan Health Plan Sr Hmo | $112 | 126% |
| Self-Pay | $112 | 126% |
| Alignment Health Plan | $116 | 130% |
| Molina Healthcare | $116 | 130% |
| Molina Healthcare Of California | $116 - $140 | 130% |
| Inter Valley Health Plan | $118 | 133% |
| National Disaster Medical System | $123 | 138% |
| San Miguel Health Plan | $123 | 138% |
| Pacificare Of California Inc | $132 | 148% |
| Pacificare Ppo | $132 | 148% |
| Chinatown Service Center Pace | $134 | 151% |
| Ahmc Health Epo | $140 | 157% |
| Knox-Keene Act | $140 | 157% |
| Preferred Health Network | $141 | 159% |
| Interplan | $144 - $643 | 162% |
| Athens Administrators | $149 | 168% |
| Multiplan | $149 - $728 | 168% |
| Other Non-Contracted Workers Compensation | $149 | 168% |
| Family Health Alliance | $155 - $257 | 174% |
| Health Net Comm/Hmo | $178 - $471 | 200% |
| Allied Physicians Risk Pool | $181 - $300 | 204% |
| Allied Physicians Risk Pool Agreement | $181 - $300 | 204% |
| Healthnet Medi Cal Cap | $181 - $300 | 204% |
| Pipa Risk Pool Agreement | $181 - $300 | 204% |
| Health Net Inc | $182 | 205% |
| Cigna | $199 | 224% |
| Molina Medical Group | $201 - $334 | 226% |
| Health Net Foundation Comm/Sr (Family Health Alliance) | $206 - $343 | 232% |
| Health Net Foundation M Cal (Family Health Alliance) | $206 - $343 | 232% |
| Phys Assoc Of San Gab Valley | $206 - $343 | 232% |
| Allied Physicians Med Grp | $258 - $428 | 290% |
| Alhambra Hospital | $310 - $514 | 349% |
| Care 1St Health Plan | $310 - $514 | 349% |
| One Health Plan | $361 - $600 | 406% |
| Fmc Los Angeles Co Epo | $387 - $643 | 435% |
| Corvel Corporation | $413 - $686 | 465% |
| Americas Health Plan | $439 - $728 | 494% |
| Health Payors Organization | $464 - $771 | 522% |
| East La Reg Ctr | $516 - $857 | 580% |
| Non Contract Commercial | $516 - $857 | 580% |
| One Legacy | $516 - $857 | 580% |
| Private Pay | $516 - $857 | 580% |