CMS Price Transparency Data

Blood test, lipase

Facility: Adventist Health Simi Valley

Billing Code: 83690 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 83690
  • Insurance Median: $56
  • Cash Discount Price: $43
  • vs. Medicare Baseline: 8.13x Medicare
The contracted insurance negotiated median rate for a Blood test, lipase at Adventist Health Simi Valley is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $6.89, this hospital’s rate is 8.13x the Medicare baseline. Located in 2975 N Sycamore Dr, Simi Valley, CA.
Cash / Self-Pay
$43

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.89

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.89 (100%)
Cash / Self-Pay: $43 (624%)
Insurance Median: $56 (813%)
Cash: $43 (624% of Medicare)
Ins. Median: $56 (813% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.89 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 813% of the Medicare baseline (a markup of 713%). 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 $2 - $124 29%
Vchcp - All Plans $2 - $166 29%
Aetna $3 - $228 44%
Blue Shield - All Other Plans $3 - $190 44%
Hpn - All Other Plans $3 - $208 44%
Hpn Senior Hmo $3 - $173 44%
Kaiser - All Plans $3 - $207 44%
UnitedHealthcare $3 - $172 44%
Western Growers - All Plans $3 - $215 44%
First Health - All Plans $4 - $269 58%
Phcs Ppo - All Plans $4 - $269 58%
Scan Mcr Adv - All Plans $4 - $248 58%
Ahf - All Plans $5 - $352 73%
Beech Street Ppo - All Plans $5 - $310 73%
Choicecare Ppo - All Plans $5 - $310 73%
Corvel Corp - All Plans $5 - $331 73%
Fpn Ppo - All Plans $5 - $373 73%
Health Net - All Plans $5 - $312 73%
Hmn Ppo/Epo - All Plans $5 - $352 73%
Interplan Ppo - All Plans $5 - $331 73%
Multiplan Ppo - All Plans $5 - $344 73%
Trpn Ppo - All Plans $5 - $352 73%
Gold Coast Mcal - All Plans $6 - $10 87%
Blue Shield Mcare $7 102%
Facey Medical Mdcare $7 102%
Medicare (plans) $7 102%
Tricare $7 102%
Facey Medical Hmo/Pos - All Other Plans $8 116%
Ah Employee Health Plan - All Plans $12 174%
Centivo - All Plans $16 232%
Cigna $22 319%
Bc Exchange $56 813%
Bc Non Mcs $62 900%
Bc Mcs - All Other Plans $74 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