CMS Price Transparency Data
Physical therapy (functional capacity test)
Facility: Children's Hosp of Los Angeles
Billing Code: 97750 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97750
- Insurance Median: $3
- Cash Discount Price: $5
- vs. Medicare Baseline: 0.09x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Children's Hosp of Los Angeles is $3. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 0.09x the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.
Cash / Self-Pay
$5
Average discount available for prompt cash payment at this facility.
Insurance Median
$3
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$33.73
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $33.73 (100%)
Cash / Self-Pay: $5 (15%)
Insurance Median: $3 (9%)
Cash: $5 (15% of Medicare)
Ins. Median: $3 (9% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $33.73 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 |
|---|---|---|
| Kaiser | $3 | 9% |
| Blue Shield | $3 - $6 | 9% |
| Calvo Selectcare | $4 | 12% |
| Embassy - Saudi Arabia | $4 | 12% |
| Interlink Health Services | $4 | 12% |
| Redlands Community Hospital | $4 | 12% |
| Memorialcare Med Foundation | $4 | 12% |
| Alhambra Hospital Medical Center | $4 - $6 | 12% |
| Star Healthcare Network Commercial | $4 | 12% |
| Citrus Valley Phys Grp | $4 | 12% |
| Associated Hispanic Physicians IPA | $4 - $6 | 12% |
| Preferred IPA - Commercial | $4 | 12% |
| Axis Services International | $4 | 12% |
| Serra Community Med Clinic - Commercial | $4 | 12% |
| Sierra Health and Life Insurance Company | $4 | 12% |
| Access Medical Group | $4 | 12% |
| Delta Health Systems | $4 | 12% |
| Seaside Health Plan | $4 - $6 | 12% |
| UnitedHealthcare | $4 - $202 | 12% |
| Prospect Medical Group | $4 | 12% |
| Los Angeles Medical Center IPA | $4 - $6 | 12% |
| Allied Pacific IPA | $4 - $6 | 12% |
| Self-Pay | $4 | 12% |
| Ventura County Health Plan | $4 - $628 | 12% |
| Imperial Health Holdings Medical Group | $4 - $6 | 12% |
| Emanate Health Medical Center Commercial | $4 | 12% |
| Intl - Concierge Healthcare Services | $4 | 12% |
| Embassy - Kuwait | $4 | 12% |
| Seoul Medical Group | $4 | 12% |
| Intl - Erv Travel Services | $4 | 12% |
| Intl - Quality Health Management | $4 - $6 | 12% |
| Heritage Provider Network | $4 - $6 | 12% |
| Intl - Msh China Enterprise Services | $4 | 12% |
| Angeles IPA | $4 - $6 | 12% |
| Hispanic Physician IPA | $4 - $6 | 12% |
| Marian Health Services | $4 | 12% |
| Korean American Med Grp | $4 | 12% |
| Lakewood Health Plan | $4 | 12% |
| Multiplan | $4 | 12% |
| Primecare Medical Network | $4 | 12% |
| Plotkin Health | $4 | 12% |
| Cedar Sinai Med Grp | $4 | 12% |
| Health Net | $4 - $8 | 12% |
| Bright Medical Associates | $4 | 12% |
| Private Hlthcare System | $4 | 12% |
| Prime Health Services | $4 | 12% |
| Beaver Medical Group | $4 | 12% |
| Family Care Specialists | $4 - $455 | 12% |
| Intl - Aixin Life Insurance Co | $4 - $6 | 12% |
| Sanus Health | $4 | 12% |
| Intl - Global Excel Management | $4 - $12 | 12% |
| Blue Cross Blue Shield | $4 - $448 | 12% |
| Adventist Health Physicians | $5 - $11 | 15% |
| Southern Atlantic Medical Group Mmc | $5 - $10 | 15% |
| Embassy - All Others | $5 | 15% |
| Self-Pay International | $5 | 15% |
| Altamed | $6 | 18% |
| El Proyecto Del Barrio | $6 - $108 | 18% |
| La Care | $6 | 18% |
| Gold Coast Health Plan | $6 | 18% |
| Crown City Medical Group | $6 | 18% |
| Medi-Cal | $6 | 18% |
| Global Care Medical Group | $6 - $108 | 18% |
| Karing Physicians Medical Group | $6 - $178 | 18% |
| Avalon IPA | $6 - $166 | 18% |
| Cencal Health | $6 | 18% |
| Superior Choice Medical Group | $6 - $248 | 18% |
| Exceptional Care Medical Group | $6 - $536 | 18% |
| Pacific Alliance Medical Center | $6 | 18% |
| St. John's Health Clinic | $6 | 18% |
| Asian Community Medical Group | $6 - $208 | 18% |
| Watts Healthcare Mmc | $6 - $108 | 18% |
| Mabuhay Medical Group | $6 - $166 | 18% |
| Champus | $6 | 18% |
| Community Family Care IPA | $6 | 18% |
| Community Care IPA Mmc | $6 - $167 | 18% |
| Serra Community Med Clinic | $6 | 18% |
| Primary Care and Pediatric IPA | $6 - $166 | 18% |
| Preferred IPA | $6 | 18% |
| Facey Medical Group | $6 | 18% |
| Southland San Gabriel Valley Medical Group | $6 - $238 | 18% |
| Healthy New Life Medical Corp | $6 - $208 | 18% |
| Cal Care IPA | $6 | 18% |
| Hollywood Presbyterian Medical Center | $6 | 18% |
| Point Comfort Underwriters | $6 | 18% |
| Culinary Health Fund | $6 | 18% |
| Employee Health Systems Med Grp | $6 | 18% |
| Care 1St | $6 | 18% |
| Caloptima | $6 | 18% |
| St Francis Medical Center | $6 | 18% |
| Health Care La IPA | $6 - $108 | 18% |
| White Memorial Medical Center | $6 | 18% |
| Noble Community Medical Associates | $6 - $178 | 18% |
| Dignity Health | $6 | 18% |
| Inland Empire Health Plan | $6 | 18% |
| Choc Health Alliance | $6 | 18% |
| Premier Physicians Ntwk | $6 - $108 | 18% |
| San Judas Med Grp | $6 | 18% |
| Souther California Hosp System - Mmc | $6 | 18% |
| Applecare Medical Group | $6 - $519 | 18% |
| Serendib Healthways Mmc | $6 - $150 | 18% |
| Bella Vista Med Grp | $6 - $108 | 18% |
| California Pacific Physicians Medical Group | $6 - $208 | 18% |
| Valley Presbyterian Hospital | $6 | 18% |
| Medicare (plans) | $6 | 18% |
| Accountable Health | $6 - $142 | 18% |
| Family Health Alliance Med Grp | $6 - $174 | 18% |
| Kern Family Health Plan | $6 | 18% |
| Centinela Valley IPA | $6 - $108 | 18% |
| Beverly Hospital | $6 | 18% |
| Medicaid / KanCare | $6 | 18% |
| Molina | $6 | 18% |
| Axminster Medical Group | $6 | 18% |
| Regent Medical Group | $6 - $178 | 18% |
| Providence Health Network | $464 | 1376% |