CMS Price Transparency Data
New patient office visit (30-44 min)
Facility: Children's Hosp of Los Angeles
Billing Code: 99203 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99203
- Insurance Median: $32
- Cash Discount Price: $46
- vs. Medicare Baseline: 0.27x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Children's Hosp of Los Angeles is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.27x the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.
Cash / Self-Pay
$46
Average discount available for prompt cash payment at this facility.
Insurance Median
$32
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$117.57
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $46 (39%)
Insurance Median: $32 (27%)
Cash: $46 (39% of Medicare)
Ins. Median: $32 (27% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $117.57 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
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Input your details and click calculate to compare out-of-pocket costs.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $14 - $46 | 12% |
| Shriners Hospital | $14 | 12% |
| Beech Street | $18 | 15% |
| Incentive Health Network | $18 | 15% |
| Non-Contract Payors | $18 | 15% |
| Health Net | $19 - $58 | 16% |
| Kaiser | $21 - $26 | 18% |
| Emanate Health Medical Center Mmc | $21 | 18% |
| Facey Medical Group | $22 | 19% |
| St. John's Health Clinic | $22 | 19% |
| Axminster Medical Group | $22 | 19% |
| Exceptional Care Medical Group | $23 - $46 | 20% |
| Gemcare IPA | $23 - $60 | 20% |
| Managed Care Systems | $23 - $28 | 20% |
| Altamed | $23 - $46 | 20% |
| Citrus Valley Phys Grp | $23 - $30 | 20% |
| Accarent Health | $23 | 20% |
| Mercy Care | $23 | 20% |
| La Care | $23 - $46 | 20% |
| Staywell Insurance | $23 | 20% |
| Pioneer Prov Ntwk | $23 | 20% |
| Sansum Clinic | $23 | 20% |
| Book Md | $24 | 20% |
| Applecare Medical Group | $24 - $46 | 20% |
| Good Samaritan Medical Group | $24 | 20% |
| Blue Shield | $25 - $46 | 21% |
| Bella Vista Med Grp | $25 - $75 | 21% |
| Intl - Global Excel Management | $25 - $92 | 21% |
| Intl - Quality Health Management | $25 - $46 | 21% |
| Premier Physicians Ntwk | $25 - $75 | 21% |
| Aetna | $25 | 21% |
| Centinela Valley IPA | $25 - $75 | 21% |
| Global Care Medical Group | $25 - $75 | 21% |
| Choice Medical Group | $25 | 21% |
| Health Care La IPA | $25 - $75 | 21% |
| Culinary Health Fund | $25 - $46 | 21% |
| Intl - Global Medical Management | $25 | 21% |
| Community Care | $25 | 21% |
| National Healthcare Solutions | $25 | 21% |
| Blue Cross Blue Shield | $27 - $46 | 23% |
| Seoul Medical Group | $27 | 23% |
| Access Medical Group | $27 - $59 | 23% |
| Delta Health Systems | $28 | 24% |
| Allied Pacific IPA | $28 - $110 | 24% |
| Ventura County Health Plan | $28 | 24% |
| Sanus Health | $28 | 24% |
| Los Angeles Medical Center IPA | $28 - $46 | 24% |
| UnitedHealthcare | $28 - $46 | 24% |
| Private Hlthcare System | $28 | 24% |
| Preferred IPA - Commercial | $28 | 24% |
| Self-Pay | $28 | 24% |
| Heritage Provider Network | $28 - $131 | 24% |
| Emanate Health Medical Center Commercial | $28 | 24% |
| Family Care Specialists | $28 - $50 | 24% |
| Southern Atlantic Medical Group Mmc | $28 - $46 | 24% |
| Bright Medical Associates | $28 | 24% |
| Alhambra Hospital Medical Center | $28 - $46 | 24% |
| Sierra Health and Life Insurance Company | $29 | 25% |
| Cedar Sinai Med Grp | $30 | 26% |
| Intl - Msh China Enterprise Services | $30 | 26% |
| Intl - Concierge Healthcare Services | $30 | 26% |
| Calvo Selectcare | $30 | 26% |
| Serra Community Med Clinic - Commercial | $30 | 26% |
| Embassy - Saudi Arabia | $30 | 26% |
| Intl - Aixin Life Insurance Co | $30 - $46 | 26% |
| Lakewood Health Plan | $30 | 26% |
| Star Healthcare Network Commercial | $30 | 26% |
| Axis Services International | $30 | 26% |
| Marian Health Services | $30 | 26% |
| Prime Health Services | $30 | 26% |
| Plotkin Health | $30 | 26% |
| Redlands Community Hospital | $30 - $65 | 26% |
| Intl - Erv Travel Services | $30 - $32 | 26% |
| Seaside Health Plan | $30 - $46 | 26% |
| Multiplan | $32 | 27% |
| Korean American Med Grp | $32 | 27% |
| Memorialcare Med Foundation | $32 | 27% |
| Beaver Medical Group | $32 | 27% |
| Primecare Medical Network | $32 | 27% |
| Angeles IPA | $32 - $128 | 27% |
| Prospect Medical Group | $34 | 29% |
| Hispanic Physician IPA | $34 - $46 | 29% |
| Interlink Health Services | $34 | 29% |
| Associated Hispanic Physicians IPA | $34 - $46 | 29% |
| Embassy - Kuwait | $34 | 29% |
| Self-Pay International | $37 | 31% |
| Embassy - All Others | $37 | 31% |
| Pacific Alliance Medical Center | $42 - $46 | 36% |
| Medicare (plans) | $45 | 38% |
| Superior Choice Medical Group | $46 | 39% |
| Community Family Care IPA | $46 | 39% |
| Champus | $46 | 39% |
| Serra Community Med Clinic | $46 | 39% |
| Adventist Health Physicians | $46 | 39% |
| Crown City Medical Group | $46 - $54 | 39% |
| Healthy New Life Medical Corp | $46 | 39% |
| Avalon IPA | $46 | 39% |
| El Proyecto Del Barrio | $46 | 39% |
| Care 1St | $46 | 39% |
| Southland San Gabriel Valley Medical Group | $46 | 39% |
| Point Comfort Underwriters | $46 | 39% |
| San Judas Med Grp | $46 | 39% |
| Primary Care and Pediatric IPA | $46 | 39% |
| Cal Care IPA | $46 | 39% |
| Asian Community Medical Group | $46 | 39% |
| California Pacific Physicians Medical Group | $46 | 39% |
| Watts Healthcare Mmc | $46 | 39% |
| Inland Empire Health Plan | $46 | 39% |
| Kern Family Health Plan | $46 | 39% |
| Dignity Health | $46 | 39% |
| Choc Health Alliance | $46 | 39% |
| Regent Medical Group | $46 | 39% |
| White Memorial Medical Center | $46 | 39% |
| Gold Coast Health Plan | $46 | 39% |
| Mabuhay Medical Group | $46 | 39% |
| Beverly Hospital | $46 | 39% |
| Imperial Health Holdings Medical Group | $46 | 39% |
| Serendib Healthways Mmc | $46 | 39% |
| Caloptima | $46 | 39% |
| Karing Physicians Medical Group | $46 | 39% |
| Medi-Cal | $46 | 39% |
| Cencal Health | $46 | 39% |
| Souther California Hosp System - Mmc | $46 | 39% |
| Preferred IPA | $46 | 39% |
| Family Health Alliance Med Grp | $46 | 39% |
| Noble Community Medical Associates | $46 | 39% |
| Accountable Health | $46 | 39% |
| Molina | $46 | 39% |
| Hollywood Presbyterian Medical Center | $46 | 39% |
| St Francis Medical Center | $46 | 39% |
| Employee Health Systems Med Grp | $46 - $54 | 39% |
| Valley Presbyterian Hospital | $46 | 39% |
| Community Care IPA Mmc | $46 | 39% |