CMS Price Transparency Data

X-ray, ankle

Facility: Adventist Health Simi Valley

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73610
  • Insurance Median: $416
  • Cash Discount Price: $160
  • vs. Medicare Baseline: 4.68x Medicare
The contracted insurance negotiated median rate for a X-ray, ankle at Adventist Health Simi Valley is $416. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.68x the Medicare baseline. Located in 2975 N Sycamore Dr, Simi Valley, CA.
Cash / Self-Pay
$160

Average discount available for prompt cash payment at this facility.

Insurance Median
$416

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $160 (180%)
Insurance Median: $416 (468%)
Cash: $160 (180% of Medicare)
Ins. Median: $416 (468% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 468% of the Medicare baseline (a markup of 368%). 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
Hpn Senior Hmo $15 - $626 17%
UnitedHealthcare $15 - $623 17%
Vchcp - All Plans $15 - $601 17%
Western Growers - All Plans $16 - $631 18%
Blue Shield - All Other Plans $17 - $689 19%
Kaiser - All Plans $18 - $751 20%
Hpn - All Other Plans $19 - $754 21%
Aetna $20 - $826 22%
Scan Mcr Adv - All Plans $22 - $901 25%
First Health - All Plans $24 - $976 27%
Phcs Ppo - All Plans $24 - $976 27%
Beech Street Ppo - All Plans $28 - $1,126 31%
Choicecare Ppo - All Plans $28 - $1,126 31%
Health Net - All Plans $28 - $1,132 31%
Corvel Corp - All Plans $30 - $1,202 34%
Interplan Ppo - All Plans $30 - $1,202 34%
Ahf - All Plans $31 - $1,277 35%
Hmn Ppo/Epo - All Plans $31 - $1,277 35%
Multiplan Ppo - All Plans $31 - $1,247 35%
Trpn Ppo - All Plans $31 - $1,277 35%
Fpn Ppo - All Plans $33 - $1,352 37%
Gold Coast Mcal - All Plans $37 - $44 42%
Ehn - All Plans $50 56%
Blue Shield Mcare $112 126%
Facey Medical Mdcare $112 126%
Medicare (plans) $112 126%
Tricare $112 126%
Bc Exchange $123 138%
Facey Medical Hmo/Pos - All Other Plans $134 151%
Bc Non Mcs $136 153%
Bc Mcs - All Other Plans $164 184%
Ah Employee Health Plan - All Plans $201 226%
Centivo - All Plans $252 283%
Cigna $293 330%

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