CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: Children's Hosp of Los Angeles
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $13
- Cash Discount Price: $20
- vs. Medicare Baseline: 0.10x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Children's Hosp of Los Angeles is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.10x the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.
Cash / Self-Pay
$20
Average discount available for prompt cash payment at this facility.
Insurance Median
$13
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$135.6
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $20 (15%)
Insurance Median: $13 (10%)
Cash: $20 (15% of Medicare)
Ins. Median: $13 (10% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $135.6 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.
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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 |
|---|---|---|
| Primecare Medical Network | $14 | 10% |
| Intl - Erv Travel Services | $14 | 10% |
| Angeles IPA | $14 - $128 | 10% |
| Korean American Med Grp | $14 | 10% |
| Beaver Medical Group | $14 | 10% |
| Blue Cross Blue Shield | $14 - $20 | 10% |
| Memorialcare Med Foundation | $14 | 10% |
| Multiplan | $14 | 10% |
| UnitedHealthcare | $14 - $20 | 10% |
| Hispanic Physician IPA | $15 - $20 | 11% |
| Associated Hispanic Physicians IPA | $15 - $20 | 11% |
| Prospect Medical Group | $15 | 11% |
| Interlink Health Services | $15 | 11% |
| Embassy - Kuwait | $15 | 11% |
| Self-Pay International | $16 | 12% |
| Embassy - All Others | $16 | 12% |
| Souther California Hosp System - Mmc | $20 | 15% |
| Cencal Health | $20 | 15% |
| Crown City Medical Group | $20 - $54 | 15% |
| Valley Presbyterian Hospital | $20 | 15% |
| Employee Health Systems Med Grp | $20 - $54 | 15% |
| Superior Choice Medical Group | $20 | 15% |
| San Judas Med Grp | $20 | 15% |
| Premier Physicians Ntwk | $20 - $75 | 15% |
| Karing Physicians Medical Group | $20 | 15% |
| Intl - Aixin Life Insurance Co | $20 | 15% |
| Health Care La IPA | $20 - $75 | 15% |
| Los Angeles Medical Center IPA | $20 | 15% |
| Blue Shield | $20 | 15% |
| Care 1St | $20 | 15% |
| Heritage Provider Network | $20 - $131 | 15% |
| Gold Coast Health Plan | $20 | 15% |
| Pacific Alliance Medical Center | $20 - $42 | 15% |
| Southern Atlantic Medical Group Mmc | $20 | 15% |
| Molina | $20 | 15% |
| Alhambra Hospital Medical Center | $20 | 15% |
| Culinary Health Fund | $20 | 15% |
| Primary Care and Pediatric IPA | $20 | 15% |
| St Francis Medical Center | $20 | 15% |
| Choc Health Alliance | $20 | 15% |
| Noble Community Medical Associates | $20 | 15% |
| Hollywood Presbyterian Medical Center | $20 | 15% |
| Exceptional Care Medical Group | $20 | 15% |
| Family Care Specialists | $20 - $50 | 15% |
| Seaside Health Plan | $20 | 15% |
| Preferred IPA | $20 | 15% |
| Altamed | $20 - $25 | 15% |
| Intl - Quality Health Management | $20 | 15% |
| Medicaid / KanCare | $20 | 15% |
| Regent Medical Group | $20 | 15% |
| Champus | $20 | 15% |
| California Pacific Physicians Medical Group | $20 | 15% |
| Imperial Health Holdings Medical Group | $20 | 15% |
| Family Health Alliance Med Grp | $20 | 15% |
| Point Comfort Underwriters | $20 | 15% |
| White Memorial Medical Center | $20 | 15% |
| Medi-Cal | $20 | 15% |
| Dignity Health | $20 | 15% |
| Asian Community Medical Group | $20 | 15% |
| La Care | $20 | 15% |
| Accountable Health | $20 | 15% |
| Cal Care IPA | $20 | 15% |
| Serra Community Med Clinic | $20 | 15% |
| Community Care IPA Mmc | $20 | 15% |
| Healthy New Life Medical Corp | $20 | 15% |
| Medicare (plans) | $20 | 15% |
| Allied Pacific IPA | $20 - $110 | 15% |
| Bella Vista Med Grp | $20 - $75 | 15% |
| Applecare Medical Group | $20 | 15% |
| Caloptima | $20 | 15% |
| Global Care Medical Group | $20 - $75 | 15% |
| Health Net | $20 - $25 | 15% |
| Beverly Hospital | $20 | 15% |
| Adventist Health Physicians | $20 | 15% |
| Inland Empire Health Plan | $20 | 15% |
| Southland San Gabriel Valley Medical Group | $20 | 15% |
| Centinela Valley IPA | $20 - $75 | 15% |
| Kern Family Health Plan | $20 | 15% |
| Avalon IPA | $20 | 15% |
| Mabuhay Medical Group | $20 | 15% |
| El Proyecto Del Barrio | $20 | 15% |
| Serendib Healthways Mmc | $20 | 15% |
| Community Family Care IPA | $20 | 15% |
| Watts Healthcare Mmc | $20 | 15% |
| Intl - Global Excel Management | $40 | 29% |
| Access Medical Group | $59 | 44% |
| Gemcare IPA | $60 | 44% |
| Redlands Community Hospital | $65 | 48% |