CMS Price Transparency Data

Blood test, potassium

Facility: Adventist Health Simi Valley

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84132
  • Insurance Median: $41
  • Cash Discount Price: $13
  • vs. Medicare Baseline: 8.61x Medicare
The contracted insurance negotiated median rate for a Blood test, potassium at Adventist Health Simi Valley is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 8.61x the Medicare baseline. Located in 2975 N Sycamore Dr, Simi Valley, CA.
Cash / Self-Pay
$13

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.76 (100%)
Cash / Self-Pay: $13 (273%)
Insurance Median: $41 (861%)
Cash: $13 (273% of Medicare)
Ins. Median: $41 (861% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.76 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 861% of the Medicare baseline (a markup of 761%). 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.

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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
Ehn - All Plans $1 - $82 21%
Hpn Senior Hmo $1 - $115 21%
UnitedHealthcare $1 - $114 21%
Vchcp - All Plans $1 - $110 21%
Aetna $2 - $151 42%
Blue Shield - All Other Plans $2 - $126 42%
First Health - All Plans $2 - $179 42%
Hpn - All Other Plans $2 - $138 42%
Kaiser - All Plans $2 - $138 42%
Phcs Ppo - All Plans $2 - $179 42%
Scan Mcr Adv - All Plans $2 - $165 42%
Western Growers - All Plans $2 - $143 42%
Ahf - All Plans $3 - $234 63%
Beech Street Ppo - All Plans $3 - $206 63%
Choicecare Ppo - All Plans $3 - $206 63%
Corvel Corp - All Plans $3 - $220 63%
Fpn Ppo - All Plans $3 - $248 63%
Gold Coast Mcal - All Plans $3 - $6 63%
Health Net - All Plans $3 - $207 63%
Hmn Ppo/Epo - All Plans $3 - $234 63%
Interplan Ppo - All Plans $3 - $220 63%
Multiplan Ppo - All Plans $3 - $228 63%
Trpn Ppo - All Plans $3 - $234 63%
Blue Shield Mcare $5 105%
Facey Medical Mdcare $5 105%
Medicare (plans) $5 105%
Tricare $5 105%
Facey Medical Hmo/Pos - All Other Plans $6 126%
Ah Employee Health Plan - All Plans $9 189%
Centivo - All Plans $11 231%
Cigna $15 315%
Bc Exchange $38 798%
Bc Non Mcs $42 882%
Bc Mcs - All Other Plans $50 1050%

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