CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Adventist Health Simi Valley

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $566
  • Cash Discount Price: $175
  • vs. Medicare Baseline: 3.61x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Adventist Health Simi Valley is $566. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $175. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.61x the Medicare baseline. Located in 2975 N Sycamore Dr, Simi Valley, CA.
Cash / Self-Pay
$175

Average discount available for prompt cash payment at this facility.

Insurance Median
$566

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)
Cash / Self-Pay: $175 (111%)
Insurance Median: $566 (361%)
Cash: $175 (111% of Medicare)
Ins. Median: $566 (361% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $156.98 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 361% of the Medicare baseline (a markup of 261%). 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 $125 80%
Blue Shield Mcare $179 114%
Facey Medical Mdcare $179 114%
Medicare (plans) $179 114%
Tricare $179 114%
UnitedHealthcare $179 - $188 114%
Facey Medical Hmo/Pos - All Other Plans $215 137%
Gold Coast Mcal - All Plans $273 174%
Ah Employee Health Plan - All Plans $322 205%
Centivo - All Plans $403 257%
Vchcp - All Plans $437 278%
Hpn Senior Hmo $455 290%
Western Growers - All Plans $459 292%
Blue Shield - All Other Plans $501 319%
Kaiser - All Plans $546 348%
Hpn - All Other Plans $548 349%
Cigna $583 371%
Aetna $601 383%
Scan Mcr Adv - All Plans $655 417%
First Health - All Plans $710 452%
Phcs Ppo - All Plans $710 452%
Bc Exchange $795 506%
Beech Street Ppo - All Plans $819 522%
Choicecare Ppo - All Plans $819 522%
Health Net - All Plans $823 524%
Corvel Corp - All Plans $874 557%
Interplan Ppo - All Plans $874 557%
Bc Non Mcs $884 563%
Multiplan Ppo - All Plans $906 577%
Ahf - All Plans $928 591%
Hmn Ppo/Epo - All Plans $928 591%
Trpn Ppo - All Plans $928 591%
Fpn Ppo - All Plans $983 626%
Bc Mcs - All Other Plans $1,060 675%

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