CMS Price Transparency Data
Physical therapy (neuromuscular re-education)
Facility: Children's Hosp of Los Angeles
Billing Code: 97112 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97112
- Insurance Median: $46
- Cash Discount Price: $76
- vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) 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 $76. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.41x the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.
Cash / Self-Pay
$76
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
$32.73
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $32.73 (100%)
Cash / Self-Pay: $76 (232%)
Insurance Median: $46 (141%)
Cash: $76 (232% of Medicare)
Ins. Median: $46 (141% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $32.73 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
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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 |
|---|---|---|
| Inland Empire Health Plan | $7 - $36 | 21% |
| Medi-Cal | $7 - $14 | 21% |
| Molina | $7 - $37 | 21% |
| Medicaid / KanCare | $14 - $85 | 43% |
| Shriners Hospital | $14 - $26 | 43% |
| Altamed | $16 - $85 | 49% |
| Caloptima | $17 - $85 | 52% |
| Beech Street | $18 - $34 | 55% |
| Incentive Health Network | $18 - $34 | 55% |
| Non-Contract Payors | $18 - $34 | 55% |
| Valley Presbyterian Hospital | $18 - $85 | 55% |
| Health Net | $19 - $106 | 58% |
| La Care | $19 - $85 | 58% |
| Cigna | $21 - $40 | 64% |
| Emanate Health Medical Center Mmc | $21 - $38 | 64% |
| Kaiser | $21 - $48 | 64% |
| Axminster Medical Group | $22 - $100 | 67% |
| Choc Health Alliance | $22 | 67% |
| Facey Medical Group | $22 - $100 | 67% |
| St Francis Medical Center | $22 - $85 | 67% |
| St. John'S Health Clinic | $22 - $100 | 67% |
| Accarent Health | $23 - $42 | 70% |
| Citrus Valley Phys Grp | $23 - $55 | 70% |
| Gemcare Ipa | $23 - $42 | 70% |
| Managed Care Systems | $23 - $42 | 70% |
| Mercy Care | $23 - $42 | 70% |
| Pioneer Prov Ntwk | $23 - $42 | 70% |
| Sansum Clinic | $23 - $42 | 70% |
| Staywell Insurance | $23 - $42 | 70% |
| Aetna | $24 - $47 | 73% |
| Applecare Medical Group | $24 - $519 | 73% |
| Book Md | $24 - $44 | 73% |
| Good Samaritan Medical Group | $24 - $45 | 73% |
| Bella Vista Med Grp | $25 - $108 | 76% |
| Blue Shield | $25 - $85 | 76% |
| Centinela Valley Ipa | $25 - $108 | 76% |
| Choice Medical Group | $25 - $47 | 76% |
| Community Care | $25 - $47 | 76% |
| Culinary Health Fund | $25 - $72 | 76% |
| Global Care Medical Group | $25 - $108 | 76% |
| Health Care La Ipa | $25 - $108 | 76% |
| Intl - Global Excel Management | $25 - $72 | 76% |
| Intl - Global Medical Management | $25 - $47 | 76% |
| Intl - Quality Health Management | $25 - $78 | 76% |
| National Healthcare Solutions | $25 - $47 | 76% |
| Premier Physicians Ntwk | $25 - $108 | 76% |
| Community Family Care Ipa | $26 - $85 | 79% |
| Hollywood Presbyterian Medical Center | $26 - $85 | 79% |
| Access Medical Group | $27 - $50 | 82% |
| Blue Cross Blue Shield | $27 - $448 | 82% |
| Seoul Medical Group | $27 - $50 | 82% |
| Alhambra Hospital Medical Center | $28 - $85 | 86% |
| Allied Pacific Ipa | $28 - $85 | 86% |
| Bright Medical Associates | $28 - $51 | 86% |
| Delta Health Systems | $28 - $51 | 86% |
| Emanate Health Medical Center Commercial | $28 - $51 | 86% |
| Family Care Specialists | $28 - $455 | 86% |
| Heritage Provider Network | $28 - $85 | 86% |
| Los Angeles Medical Center Ipa | $28 - $85 | 86% |
| Preferred Ipa - Commercial | $28 - $51 | 86% |
| Private Hlthcare System | $28 - $51 | 86% |
| Sanus Health | $28 - $51 | 86% |
| Self-Pay | $28 - $51 | 86% |
| UnitedHealthcare | $28 - $202 | 86% |
| Ventura County Health Plan | $28 - $628 | 86% |
| Sierra Health And Life Insurance Company | $29 - $53 | 89% |
| Axis Services International | $30 - $55 | 92% |
| Calvo Selectcare | $30 - $55 | 92% |
| Cedar Sinai Med Grp | $30 - $55 | 92% |
| Embassy - Saudi Arabia | $30 - $55 | 92% |
| Imperial Health Holdings Medical Group | $30 - $85 | 92% |
| Intl - Aixin Life Insurance Co | $30 - $78 | 92% |
| Intl - Concierge Healthcare Services | $30 - $55 | 92% |
| Intl - Erv Travel Services | $30 - $60 | 92% |
| Intl - Msh China Enterprise Services | $30 - $55 | 92% |
| Lakewood Health Plan | $30 - $55 | 92% |
| Marian Health Services | $30 - $55 | 92% |
| Plotkin Health | $30 - $55 | 92% |
| Prime Health Services | $30 - $55 | 92% |
| Redlands Community Hospital | $30 - $55 | 92% |
| Seaside Health Plan | $30 - $85 | 92% |
| Serra Community Med Clinic | $30 - $85 | 92% |
| Serra Community Med Clinic - Commercial | $30 - $55 | 92% |
| Star Healthcare Network Commercial | $30 - $55 | 92% |
| Care 1St | $31 - $85 | 95% |
| White Memorial Medical Center | $31 - $85 | 95% |
| Adventist Health Physicians | $32 - $85 | 98% |
| Angeles Ipa | $32 - $85 | 98% |
| Associated Hispanic Physicians Ipa | $32 - $85 | 98% |
| Beaver Medical Group | $32 - $60 | 98% |
| Cal Care Ipa | $32 - $85 | 98% |
| Gold Coast Health Plan | $32 - $85 | 98% |
| Hispanic Physician Ipa | $32 - $85 | 98% |
| Korean American Med Grp | $32 - $60 | 98% |
| Memorialcare Med Foundation | $32 - $60 | 98% |
| Multiplan | $32 - $60 | 98% |
| Primecare Medical Network | $32 - $60 | 98% |
| Beverly Hospital | $33 - $85 | 101% |
| Pacific Alliance Medical Center | $33 - $85 | 101% |
| Preferred Ipa | $33 - $85 | 101% |
| San Judas Med Grp | $33 - $85 | 101% |
| Cencal Health | $34 - $85 | 104% |
| Embassy - Kuwait | $34 - $64 | 104% |
| Interlink Health Services | $34 - $64 | 104% |
| Prospect Medical Group | $34 - $64 | 104% |
| Souther California Hosp System - Mmc | $34 - $85 | 104% |
| Champus | $35 | 107% |
| Crown City Medical Group | $35 - $85 | 107% |
| Employee Health Systems Med Grp | $35 - $85 | 107% |
| Point Comfort Underwriters | $35 | 107% |
| Medicare (plans) | $36 | 110% |
| Embassy - All Others | $37 - $68 | 113% |
| Self-Pay International | $37 - $68 | 113% |
| Dignity Health | $39 - $85 | 119% |
| Kern Family Health Plan | $43 - $85 | 131% |
| Accountable Health | $46 - $142 | 141% |
| Asian Community Medical Group | $46 - $208 | 141% |
| Avalon Ipa | $46 - $166 | 141% |
| California Pacific Physicians Medical Group | $46 - $208 | 141% |
| Community Care Ipa Mmc | $46 - $167 | 141% |
| El Proyecto Del Barrio | $46 - $108 | 141% |
| Exceptional Care Medical Group | $46 - $536 | 141% |
| Family Health Alliance Med Grp | $46 - $174 | 141% |
| Healthy New Life Medical Corp | $46 - $208 | 141% |
| Karing Physicians Medical Group | $46 - $178 | 141% |
| Mabuhay Medical Group | $46 - $166 | 141% |
| Noble Community Medical Associates | $46 - $178 | 141% |
| Primary Care And Pediatric Ipa | $46 - $166 | 141% |
| Regent Medical Group | $46 - $178 | 141% |
| Serendib Healthways Mmc | $46 - $150 | 141% |
| Southern Atlantic Medical Group Mmc | $46 - $85 | 141% |
| Southland San Gabriel Valley Medical Group | $46 - $238 | 141% |
| Superior Choice Medical Group | $46 - $248 | 141% |
| Watts Healthcare Mmc | $46 - $108 | 141% |
| Providence Health Network | $337 - $464 | 1030% |