CMS Price Transparency Data

Blood test, liver function panel

Facility: Adventist Health Simi Valley

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $67
  • Cash Discount Price: $21
  • vs. Medicare Baseline: 8.20x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Adventist Health Simi Valley is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 8.20x the Medicare baseline. Located in 2975 N Sycamore Dr, Simi Valley, CA.
Cash / Self-Pay
$21

Average discount available for prompt cash payment at this facility.

Insurance Median
$67

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.17 (100%)
Cash / Self-Pay: $21 (257%)
Insurance Median: $67 (820%)
Cash: $21 (257% of Medicare)
Ins. Median: $67 (820% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.17 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 820% of the Medicare baseline (a markup of 720%). 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 $4 - $226 49%
Hpn Senior Hmo $5 - $315 61%
UnitedHealthcare $5 - $313 61%
Vchcp - All Plans $5 - $302 61%
Blue Shield - All Other Plans $6 - $347 73%
Hpn - All Other Plans $6 - $379 73%
Kaiser - All Plans $6 - $378 73%
Aetna $7 - $415 86%
Western Growers - All Plans $7 - $393 86%
Blue Shield Mcare $8 98%
Facey Medical Mdcare $8 98%
First Health - All Plans $8 - $491 98%
Medicare (plans) $8 98%
Phcs Ppo - All Plans $8 - $491 98%
Scan Mcr Adv - All Plans $8 - $453 98%
Tricare $8 98%
Beech Street Ppo - All Plans $10 - $566 122%
Choicecare Ppo - All Plans $10 - $566 122%
Corvel Corp - All Plans $10 - $604 122%
Facey Medical Hmo/Pos - All Other Plans $10 122%
Health Net - All Plans $10 - $569 122%
Interplan Ppo - All Plans $10 - $604 122%
Ahf - All Plans $11 - $642 135%
Fpn Ppo - All Plans $11 - $680 135%
Gold Coast Mcal - All Plans $11 135%
Hmn Ppo/Epo - All Plans $11 - $642 135%
Multiplan Ppo - All Plans $11 - $627 135%
Trpn Ppo - All Plans $11 - $642 135%
Ah Employee Health Plan - All Plans $15 184%
Centivo - All Plans $18 220%
Cigna $26 318%
Bc Exchange $66 808%
Bc Non Mcs $73 894%
Bc Mcs - All Other Plans $88 1077%

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