CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Adventist Health Simi Valley

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $2,680
  • Cash Discount Price: $780
  • vs. Medicare Baseline: 10.99x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Adventist Health Simi Valley is $2,680. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $780. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 10.99x the Medicare baseline. Located in 2975 N Sycamore Dr, Simi Valley, CA.
Cash / Self-Pay
$780

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,680

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $780 (320%)
Insurance Median: $2,680 (1099%)
Cash: $780 (320% of Medicare)
Ins. Median: $2,680 (1099% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 1099% of the Medicare baseline (a markup of 999%). 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
Blue Shield Mcare $307 126%
Facey Medical Mdcare $307 126%
Medicare (plans) $307 126%
Tricare $307 126%
UnitedHealthcare $307 - $3,034 126%
Facey Medical Hmo/Pos - All Other Plans $368 151%
Ehn - All Plans $400 164%
Ah Employee Health Plan - All Plans $552 226%
Gold Coast Mcal - All Plans $689 283%
Centivo - All Plans $690 283%
Cigna $1,095 449%
Vchcp - All Plans $1,462 - $2,923 600%
Hpn Senior Hmo $1,524 - $2,422 625%
Western Growers - All Plans $1,535 - $3,069 630%
Bc Exchange $1,538 631%
Blue Shield - All Other Plans $1,677 - $3,354 688%
Bc Non Mcs $1,708 701%
Kaiser - All Plans $1,827 - $3,654 749%
Hpn - All Other Plans $1,834 - $3,032 752%
Aetna $2,010 - $4,019 825%
Bc Mcs - All Other Plans $2,050 841%
Scan Mcr Adv - All Plans $2,192 - $2,500 899%
First Health - All Plans $2,375 - $4,750 974%
Phcs Ppo - All Plans $2,375 - $4,750 974%
Health Net - All Plans $2,607 1069%
Beech Street Ppo - All Plans $2,740 - $5,481 1124%
Choicecare Ppo - All Plans $2,740 - $5,481 1124%
Corvel Corp - All Plans $2,923 - $5,846 1199%
Interplan Ppo - All Plans $2,923 - $5,846 1199%
Multiplan Ppo - All Plans $3,033 - $6,066 1244%
Ahf - All Plans $3,106 - $6,212 1274%
Hmn Ppo/Epo - All Plans $3,106 - $6,212 1274%
Trpn Ppo - All Plans $3,106 - $6,212 1274%
Fpn Ppo - All Plans $3,289 - $6,577 1349%

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