CMS Price Transparency Data

Varicella (chickenpox) vaccine

Facility: Children's Hosp of Los Angeles

Billing Code: 90716 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90716
Insurance Median: $46
Cash Discount Price: $70
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Varicella (chickenpox) vaccine at Children's Hosp of Los Angeles is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.

Cash / Self-Pay

$70

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Molina	$10 - $70	N/A
Medi-Cal	$10 - $70	N/A
Inland Empire Health Plan	$10 - $70	N/A
Shriners Hospital	$21	N/A
Medicaid / KanCare	$21 - $70	N/A
Incentive Health Network	$28	N/A
Beech Street	$28	N/A
Non-Contract Payors	$28	N/A
Health Net	$29 - $88	N/A
Emanate Health Medical Center Mmc	$32	N/A
Adventist Health Physicians	$33 - $70	N/A
Kaiser	$33 - $40	N/A
Axminster Medical Group	$34	N/A
Facey Medical Group	$34	N/A
St. John's Health Clinic	$34	N/A
Mercy Care	$35	N/A
La Care	$35 - $70	N/A
Citrus Valley Phys Grp	$35 - $46	N/A
Sansum Clinic	$35	N/A
Altamed	$35 - $70	N/A
UnitedHealthcare	$35 - $55	N/A
Exceptional Care Medical Group	$35 - $70	N/A
Managed Care Systems	$35	N/A
Accarent Health	$35	N/A
Staywell Insurance	$35	N/A
Gemcare IPA	$35	N/A
Pioneer Prov Ntwk	$35	N/A
Book Md	$36	N/A
Aetna	$36 - $38	N/A
Good Samaritan Medical Group	$37	N/A
Applecare Medical Group	$37 - $70	N/A
National Healthcare Solutions	$38	N/A
Global Care Medical Group	$38 - $70	N/A
Premier Physicians Ntwk	$38 - $70	N/A
Intl - Quality Health Management	$38 - $46	N/A
Health Care La IPA	$38 - $70	N/A
Bella Vista Med Grp	$38 - $70	N/A
Culinary Health Fund	$38	N/A
Intl - Global Excel Management	$38 - $46	N/A
Community Care	$38	N/A
Blue Shield	$38 - $70	N/A
Choice Medical Group	$38	N/A
Intl - Global Medical Management	$38	N/A
Centinela Valley IPA	$38 - $70	N/A
Access Medical Group	$41	N/A
Seoul Medical Group	$41	N/A
Blue Cross Blue Shield	$41 - $263	N/A
Preferred IPA - Commercial	$42	N/A
Heritage Provider Network	$42 - $70	N/A
Ventura County Health Plan	$42	N/A
Providence Health Network	$42	N/A
Allied Pacific IPA	$42 - $70	N/A
Delta Health Systems	$42	N/A
Family Care Specialists	$42 - $70	N/A
Private Hlthcare System	$42	N/A
Alhambra Hospital Medical Center	$42 - $70	N/A
Bright Medical Associates	$42	N/A
Los Angeles Medical Center IPA	$42 - $70	N/A
Self-Pay	$42	N/A
Emanate Health Medical Center Commercial	$42	N/A
Sanus Health	$42	N/A
Sierra Health and Life Insurance Company	$44	N/A
Axis Services International	$46	N/A
Lakewood Health Plan	$46	N/A
Redlands Community Hospital	$46	N/A
Serra Community Med Clinic - Commercial	$46	N/A
Embassy - Saudi Arabia	$46	N/A
Calvo Selectcare	$46	N/A
Prime Health Services	$46	N/A
Intl - Erv Travel Services	$46 - $49	N/A
Cedar Sinai Med Grp	$46	N/A
Intl - Concierge Healthcare Services	$46	N/A
Intl - Msh China Enterprise Services	$46	N/A
Seaside Health Plan	$46 - $70	N/A
Star Healthcare Network Commercial	$46	N/A
Marian Health Services	$46	N/A
Intl - Aixin Life Insurance Co	$46	N/A
Plotkin Health	$46	N/A
Primecare Medical Network	$49	N/A
Memorialcare Med Foundation	$49	N/A
Angeles IPA	$49 - $70	N/A
Multiplan	$49	N/A
Beaver Medical Group	$49	N/A
Korean American Med Grp	$49	N/A
Associated Hispanic Physicians IPA	$52 - $70	N/A
Embassy - Kuwait	$52	N/A
Prospect Medical Group	$52	N/A
Interlink Health Services	$52	N/A
Hispanic Physician IPA	$52 - $70	N/A
Embassy - All Others	$56	N/A
Self-Pay International	$56	N/A
Champus	$68	N/A
Cigna	$70	N/A
St Francis Medical Center	$70	N/A
Crown City Medical Group	$70	N/A
Noble Community Medical Associates	$70	N/A
Point Comfort Underwriters	$70	N/A
San Judas Med Grp	$70	N/A
Primary Care and Pediatric IPA	$70	N/A
Community Family Care IPA	$70	N/A
Pacific Alliance Medical Center	$70	N/A
Southern Atlantic Medical Group Mmc	$70 - $112	N/A
Avalon IPA	$70	N/A
Mabuhay Medical Group	$70	N/A
Souther California Hosp System - Mmc	$70	N/A
Choc Health Alliance	$70	N/A
Care 1St	$70	N/A
Serendib Healthways Mmc	$70	N/A
Regent Medical Group	$70	N/A
Superior Choice Medical Group	$70	N/A
El Proyecto Del Barrio	$70	N/A
Cal Care IPA	$70	N/A
Serra Community Med Clinic	$70	N/A
Accountable Health	$70	N/A
Cencal Health	$70	N/A
Family Health Alliance Med Grp	$70	N/A
Employee Health Systems Med Grp	$70	N/A
Karing Physicians Medical Group	$70	N/A
Asian Community Medical Group	$70	N/A
Healthy New Life Medical Corp	$70	N/A
White Memorial Medical Center	$70	N/A
Preferred IPA	$70	N/A
Gold Coast Health Plan	$70	N/A
California Pacific Physicians Medical Group	$70	N/A
Caloptima	$70 - $178	N/A
Kern Family Health Plan	$70	N/A
Hollywood Presbyterian Medical Center	$70	N/A
Watts Healthcare Mmc	$70	N/A
Valley Presbyterian Hospital	$70	N/A
Community Care IPA Mmc	$70	N/A
Southland San Gabriel Valley Medical Group	$70	N/A
Dignity Health	$70	N/A
Beverly Hospital	$70	N/A
Imperial Health Holdings Medical Group	$70	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $70.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: 90716.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Children's Hosp of Los Angeles is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code 90716.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.