CMS Price Transparency Data

Culture, bacterial

Facility: Adventist Health Simi Valley

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $70
  • Cash Discount Price: $21
  • vs. Medicare Baseline: 8.12x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Adventist Health Simi Valley is $70. 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 $8.62, this hospital’s rate is 8.12x 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
$70

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.62

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.62 (100%)
Cash / Self-Pay: $21 (244%)
Insurance Median: $70 (812%)
Cash: $21 (244% of Medicare)
Ins. Median: $70 (812% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.62 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 812% of the Medicare baseline (a markup of 712%). 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 - $182 23%
Blue Shield - All Other Plans $3 - $278 35%
Hpn Senior Hmo $3 - $252 35%
UnitedHealthcare $3 - $251 35%
Vchcp - All Plans $3 - $242 35%
Aetna $4 - $333 46%
Hpn - All Other Plans $4 - $304 46%
Kaiser - All Plans $4 - $302 46%
Western Growers - All Plans $4 - $315 46%
First Health - All Plans $5 - $393 58%
Phcs Ppo - All Plans $5 - $393 58%
Scan Mcr Adv - All Plans $5 - $363 58%
Ahf - All Plans $6 - $514 70%
Beech Street Ppo - All Plans $6 - $454 70%
Choicecare Ppo - All Plans $6 - $454 70%
Corvel Corp - All Plans $6 - $484 70%
Health Net - All Plans $6 - $456 70%
Hmn Ppo/Epo - All Plans $6 - $514 70%
Interplan Ppo - All Plans $6 - $484 70%
Multiplan Ppo - All Plans $6 - $502 70%
Trpn Ppo - All Plans $6 - $514 70%
Fpn Ppo - All Plans $7 - $544 81%
Gold Coast Mcal - All Plans $8 - $12 93%
Blue Shield Mcare $9 104%
Facey Medical Mdcare $9 104%
Medicare (plans) $9 104%
Tricare $9 104%
Facey Medical Hmo/Pos - All Other Plans $10 116%
Ah Employee Health Plan - All Plans $16 186%
Centivo - All Plans $19 220%
Cigna $28 325%
Bc Exchange $70 812%
Bc Non Mcs $77 893%
Bc Mcs - All Other Plans $93 1079%

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