CMS Price Transparency Data

Blood antibody screen

Facility: Adventist Health Simi Valley

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $17
  • Cash Discount Price: $4
  • vs. Medicare Baseline: 0.32x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Adventist Health Simi Valley is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 0.32x the Medicare baseline. Located in 2975 N Sycamore Dr, Simi Valley, CA.
Cash / Self-Pay
$4

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)
Cash / Self-Pay: $4 (8%)
Insurance Median: $17 (32%)
Cash: $4 (8% of Medicare)
Ins. Median: $17 (32% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 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
Ehn - All Plans $3 - $63 6%
Blue Shield - All Other Plans $4 - $96 8%
Hpn Senior Hmo $4 - $87 8%
UnitedHealthcare $4 - $87 8%
Vchcp - All Plans $4 - $84 8%
Aetna $5 - $115 9%
Gold Coast Mcal - All Plans $5 9%
Hpn - All Other Plans $5 - $105 9%
Kaiser - All Plans $5 - $104 9%
Western Growers - All Plans $5 - $109 9%
First Health - All Plans $6 - $136 11%
Phcs Ppo - All Plans $6 - $136 11%
Scan Mcr Adv - All Plans $6 - $125 11%
Beech Street Ppo - All Plans $7 - $157 13%
Choicecare Ppo - All Plans $7 - $157 13%
Health Net - All Plans $7 - $158 13%
Ahf - All Plans $8 - $178 15%
Corvel Corp - All Plans $8 - $167 15%
Hmn Ppo/Epo - All Plans $8 - $178 15%
Interplan Ppo - All Plans $8 - $167 15%
Multiplan Ppo - All Plans $8 - $173 15%
Trpn Ppo - All Plans $8 - $178 15%
Fpn Ppo - All Plans $9 - $188 17%
Blue Shield Mcare $10 19%
Facey Medical Mdcare $10 19%
Medicare (plans) $10 19%
Tricare $10 19%
Facey Medical Hmo/Pos - All Other Plans $12 23%
Ah Employee Health Plan - All Plans $18 34%
Centivo - All Plans $22 41%
Cigna $26 49%
Bc Exchange $87 163%
Bc Non Mcs $97 182%
Bc Mcs - All Other Plans $117 220%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2975 N Sycamore Dr, Simi Valley, CA 93065
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals