CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Adventist Health Simi Valley

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $45
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 8.79x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Adventist Health Simi Valley is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 8.79x the Medicare baseline. Located in 2975 N Sycamore Dr, Simi Valley, CA.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$45

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5.12

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5.12 (100%)
Cash / Self-Pay: $32 (625%)
Insurance Median: $45 (879%)
Cash: $32 (625% of Medicare)
Ins. Median: $45 (879% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5.12 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 879% of the Medicare baseline (a markup of 779%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $1 - $92 20%
Aetna $2 - $168 39%
Blue Shield - All Other Plans $2 - $140 39%
Hpn - All Other Plans $2 - $154 39%
Hpn Senior Hmo $2 - $128 39%
Kaiser - All Plans $2 - $153 39%
UnitedHealthcare $2 - $127 39%
Vchcp - All Plans $2 - $122 39%
Western Growers - All Plans $2 - $159 39%
Beech Street Ppo - All Plans $3 - $230 59%
Choicecare Ppo - All Plans $3 - $230 59%
Corvel Corp - All Plans $3 - $245 59%
First Health - All Plans $3 - $199 59%
Health Net - All Plans $3 - $231 59%
Interplan Ppo - All Plans $3 - $245 59%
Phcs Ppo - All Plans $3 - $199 59%
Scan Mcr Adv - All Plans $3 - $184 59%
Ahf - All Plans $4 - $260 78%
Fpn Ppo - All Plans $4 - $275 78%
Gold Coast Mcal - All Plans $4 - $7 78%
Hmn Ppo/Epo - All Plans $4 - $260 78%
Multiplan Ppo - All Plans $4 - $254 78%
Trpn Ppo - All Plans $4 - $260 78%
Blue Shield Mcare $5 98%
Facey Medical Mdcare $5 98%
Medicare (plans) $5 98%
Tricare $5 98%
Facey Medical Hmo/Pos - All Other Plans $6 117%
Ah Employee Health Plan - All Plans $9 176%
Centivo - All Plans $12 234%
Cigna $17 332%
Bc Exchange $41 801%
Bc Non Mcs $46 898%
Bc Mcs - All Other Plans $55 1074%

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