CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Adventist Health Simi Valley

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76700
  • Insurance Median: $1,099
  • Cash Discount Price: $423
  • vs. Medicare Baseline: 10.29x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Adventist Health Simi Valley is $1,099. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $423. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.29x the Medicare baseline. Located in 2975 N Sycamore Dr, Simi Valley, CA.
Cash / Self-Pay
$423

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,099

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $423 (396%)
Insurance Median: $1,099 (1029%)
Cash: $423 (396% of Medicare)
Ins. Median: $1,099 (1029% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 1029% of the Medicare baseline (a markup of 929%). 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 $100 94%
Blue Shield Mcare $134 125%
Facey Medical Mdcare $134 125%
Medicare (plans) $134 125%
Tricare $134 125%
UnitedHealthcare $134 - $1,096 125%
Gold Coast Mcal - All Plans $147 138%
Facey Medical Hmo/Pos - All Other Plans $161 151%
Ah Employee Health Plan - All Plans $242 227%
Centivo - All Plans $303 284%
Bc Exchange $458 429%
Bc Non Mcs $508 476%
Cigna $539 505%
Bc Mcs - All Other Plans $610 571%
Vchcp - All Plans $1,056 989%
Hpn Senior Hmo $1,101 1031%
Western Growers - All Plans $1,109 1038%
Blue Shield - All Other Plans $1,212 1135%
Kaiser - All Plans $1,320 1236%
Hpn - All Other Plans $1,326 1241%
Aetna $1,453 1360%
Scan Mcr Adv - All Plans $1,585 1484%
First Health - All Plans $1,717 1608%
Phcs Ppo - All Plans $1,717 1608%
Beech Street Ppo - All Plans $1,981 1855%
Choicecare Ppo - All Plans $1,981 1855%
Health Net - All Plans $1,991 1864%
Corvel Corp - All Plans $2,113 1978%
Interplan Ppo - All Plans $2,113 1978%
Multiplan Ppo - All Plans $2,192 2052%
Ahf - All Plans $2,245 2102%
Hmn Ppo/Epo - All Plans $2,245 2102%
Trpn Ppo - All Plans $2,245 2102%
Fpn Ppo - All Plans $2,377 2225%

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