SIMI VALLEY HOSPITAL AND HEALTH CARE SERVICES
2975 Sycamore Dr, Simi Valley, CA · Adventisthealth · · NPI 1063495190
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Intrvasc Ultrasound noncoronary 1st vessel CPT 37252 | $810.24 | $5,064.00 | $77.61 – $10,870.00 | 11 |
| Intrvasc Ultrasound noncoronary addl vessel CPT 37253 | $361.60 | $2,260.00 | $61.40 – $10,870.00 | 11 |
| Intubation endotracheal emergency procedure CPT 31500 | $208.00 | $1,300.00 | $72.82 – $685.42 | 9 |
| Ionm in operatng room 15 min CPT 95940 | $10.72 | $67.00 | $27.94 – $332.00 | 16 |
| Iopamidol 250 mg iodine/ml (51 %) intravenous solution HCPCS Q9966 | $0.64 | $4.00 | $1.01 – $4.92 | 6 |
| Iopamidol 300 mg iodine/ml (61 %) intravenous solution HCPCS Q9967 | $0.72 | $4.50 | $0.41 – $5.54 | 6 |
| Iron CPT 83540 | $56.32 | $352.00 | $5.72 – $69.89 | 16 |
| Iron binding capacity CPT 83550 | $57.76 | $361.00 | $6.89 – $73.81 | 16 |
| Iron sucrose 20 mg iron/ml intravenous solution (wrapper) HCPCS J1756 | $137.94 | $862.10 | $0.66 – $545.46 | 6 |
| Irradiation of blood product each unit reference CPT 86945 | $7.20 | $45.00 | $44.39 – $194.19 | 16 |
| Irrigation implantable venous access device for drug delivery systems CPT 96523 | $51.84 | $324.00 | $75.87 – $895.00 | 12 |
| Ivc venogram s&i CPT 75825 | $1,043.20 | $6,520.00 | $213.18 – $11,749.25 | 16 |
| IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour CPT 96367 | $123.68 | $773.00 | $54.78 – $983.00 | 14 |
| IV infusion therapy/prophylaxis/diagnosis concurrent infusion CPT 96368 | $85.76 | $536.00 | $23.42 – $983.00 | 14 |
| IV infusion therapy/prophylaxis/diagnosis each additional 1 hour CPT 96366 | $76.80 | $480.00 | $34.00 – $983.00 | 14 |
| IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour CPT 96365 | $185.44 | $1,159.00 | $110.45 – $983.00 | 14 |
| Ivp w/nephrotomography CPT 74415 | $183.52 | $1,147.00 | $175.23 – $1,191.26 | 16 |
| Jak2 targeted sequence analysis CPT 81279 | $10.41 | $65.08 | $65.08 – $708.24 | 14 |
| John cunningham antibody CPT 86711 | $4.80 | $30.00 | $16.89 – $122.99 | 16 |
| Ketamine and metabolite screen - quest CPT 80357 | $16.96 | $106.00 | $9.84 – $144.06 | 4 |
| Ketone body(s) beta-hydroxybutyrate quantitative CPT 82010 | $48.16 | $301.00 | $7.15 – $87.68 | 16 |
| Ketorolac 15 mg/ml injection (wrapper) HCPCS J1885 | $8.37 | $52.30 | $0.43 – $29.04 | 14 |
| Kidney imag w/bld flow multi CPT 78709 | $537.28 | $3,358.00 | $322.22 – $2,135.54 | 18 |
| Kidney img w/bldflw sgl without rx CPT 78707 | $759.68 | $4,748.00 | $340.42 – $2,135.54 | 18 |
| Kidney (Retroperitoneal) Ultrasound (complete) CPT 76770 | $375.68 | $2,348.00 | $100.00 – $610.09 | 17 |
| Kit gene analys d816 variant CPT 81273 | $44.80 | $280.00 | $124.87 – $1,050.77 | 17 |
| Kit lead specify 5-6-5 HCPCS C1778 | $47.04 | $294.00 | $361.62 – $361.62 | 1 |
| Kit tissue closure sealant adhesive air leak progel 4 ml pleura HCPCS C2615 | $1,089.44 | $6,809.00 | $8,375.07 – $8,375.07 | 1 |
| Knee MRI (with and without contrast) CPT 73723 | $2,502.88 | $15,643.00 | $448.71 – $4,642.89 | 16 |
| Knee MRI (with contrast) CPT 73722 | $938.08 | $5,863.00 | $805.58 – $3,213.97 | 16 |
| Knee MRI (without contrast) CPT 73721 | $1,169.28 | $7,308.00 | $306.88 – $2,050.09 | 16 |
| Knee X-ray CPT 73564 | $320.96 | $2,006.00 | $48.87 – $539.49 | 16 |
| Kras gene addl variants CPT 81276 | $20.48 | $128.00 | $128.00 – $1,659.26 | 16 |
| Kras gene variants exon 2 CPT 81275 | $20.55 | $128.45 | $128.45 – $1,216.98 | 16 |
| Labetalol 5 mg/ml IV (wrapper) HCPCS J1920 | $11.29 | $70.58 | $0.67 – $64.75 | 4 |
| Lacosamide 200 mg/20 ml intravenous solution HCPCS C9254 | $123.85 | $774.05 | $0.45 – $952.08 | 4 |
| Lactate dehydrogenase (ldh) CPT 83615 | $58.56 | $366.00 | $5.37 – $64.95 | 16 |
| Lactated ringers intravenous solution HCPCS J7120 | $19.20 | $120.00 | $6.48 – $65.81 | 6 |
| Lactation class HCPCS S9443 | $179.20 | $1,120.00 | $61.00 – $169.74 | 5 |
| Lactic acid CPT 83605 | $68.80 | $430.00 | $9.41 – $115.22 | 16 |
| Lactoferrin fecal qualitative CPT 83630 | $39.36 | $246.00 | $17.45 – $98.22 | 16 |
| Lead acuity x4 spiral l 86cm HCPCS C1900 | $461.12 | $2,882.00 | $2,767.50 – $2,767.50 | 1 |
| Lead capillary CPT 83655 | $11.52 | $72.00 | $10.63 – $130.62 | 16 |
| Lead ingevity 45cm pfret MRI HCPCS C1898 | $442.56 | $2,766.00 | $707.25 – $707.25 | 1 |
| Lead tachy durata sj4 58cm HCPCS C1777 | $448.80 | $2,805.00 | $346.86 – $346.86 | 1 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $658.72 | $4,117.00 | $296.83 – $2,030.00 | 18 |
| Leishmania antibody CPT 86717 | $1.74 | $10.89 | $10.89 – $132.36 | 16 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $456.96 | $2,856.00 | $142.87 – $321.46 | 8 |
| Leukocyte phagocytosis CPT 86344 | $100.80 | $630.00 | $10.39 – $83.40 | 16 |
| Levetiracetam 500 mg/5 ml intravenous solution HCPCS J1953 | $53.87 | $336.71 | $0.12 – $48.35 | 6 |
| Levetiracetam therapeutic drug level CPT 80177 | $1.88 | $11.78 | $11.78 – $86.01 | 16 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $14.26 | $89.12 | $5.87 – $63.22 | 6 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $122.14 | $763.35 | $16.29 – $938.92 | 4 |
| Lidocaine (pf) 10 mg/ml (1 %) injection solution HCPCS J2003 | $16.98 | $106.12 | $0.13 – $57.65 | 4 |
| Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution HCPCS J2002 | $11.49 | $71.81 | $0.03 – $88.33 | 4 |
| Lidocaine therapeutic drug level CPT 80176 | $39.20 | $245.00 | $14.69 – $158.44 | 16 |
| Limited autopsy CPT 88037 | $72.96 | $456.00 | $132.53 – $560.88 | 6 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $33.04 | $206.52 | $7.46 – $254.02 | 6 |
| Lipase CPT 83690 | $66.24 | $414.00 | $6.08 – $74.25 | 16 |
| Lipoprotein blood high res frac & quant CPT 83701 | $4.32 | $27.00 | $27.00 – $262.04 | 16 |
| Lipoprotein blood quant CPT 83704 | $4.49 | $28.05 | $28.05 – $333.01 | 16 |
| Lipoprotein direct measurement hdl CPT 83718 | $23.04 | $144.00 | $6.75 – $88.27 | 16 |
| Lipoprotein direct measurement ldl CPT 83721 | $31.84 | $199.00 | $8.22 – $101.78 | 16 |
| Lithium therapeutic drug level CPT 80178 | $43.84 | $274.00 | $5.88 – $71.27 | 16 |
| Lithotripsy transluminal coronary percutaneous CPT 92972 | $2,468.80 | $15,430.00 | $125.66 – $10,870.00 | 10 |
| Liver Function Test CPT 80076 | $120.80 | $755.00 | $8.17 – $88.19 | 16 |
| Liver/spleen imag static only CPT 78215 | $351.68 | $2,198.00 | $152.65 – $1,647.04 | 18 |
| Liver/spleen imag w/vasclr flow CPT 78216 | $387.36 | $2,421.00 | $200.78 – $1,647.04 | 18 |
| Locm 100-199mg/ml iodine,1ml HCPCS Q9965 | $0.56 | $3.50 | $0.84 – $4.31 | 6 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $9.44 | $59.01 | $3.84 – $38.42 | 6 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,258.72 | $7,867.00 | $225.60 – $1,876.26 | 18 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $996.80 | $6,230.00 | $364.88 – $2,151.04 | 18 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $901.28 | $5,633.00 | $134.46 – $1,259.45 | 18 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,447.04 | $9,044.00 | $448.71 – $4,052.07 | 18 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,222.08 | $7,638.00 | $448.71 – $2,468.89 | 18 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $885.92 | $5,537.00 | $306.88 – $2,281.21 | 18 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $204.16 | $1,276.00 | $47.00 – $539.49 | 16 |
| Lumbar diskogram s&i CPT 72295 | $732.16 | $4,576.00 | $154.34 – $7,590.90 | 16 |
| Lung Function Test (Spirometry) CPT 94010 | $88.00 | $550.00 | $43.40 – $624.85 | 16 |
| Lung perfusion imaging CPT 78580 | $606.56 | $3,791.00 | $198.49 – $1,647.04 | 18 |
| Lymphatics/lymph node imaging CPT 78195 | $508.64 | $3,179.00 | $334.43 – $2,135.54 | 18 |
| Lymphocyte transformation mitogen CPT 86353 | $25.12 | $157.00 | $43.58 – $528.94 | 16 |
| Macro exam dissect molec study ea CPT 88387 | $56.00 | $350.00 | $10.39 – $79.27 | 17 |
| Macroscopic exam arthropod CPT 87168 | $27.04 | $169.00 | $4.27 – $46.06 | 16 |
| Macroscopic exam parasite CPT 87169 | $12.16 | $76.00 | $3.80 – $46.06 | 16 |
| Magnesium CPT 83735 | $59.84 | $374.00 | $5.96 – $71.85 | 16 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $18.79 | $117.44 | $1.01 – $28.86 | 6 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $42.56 | $266.00 | $20.64 – $536.00 | 18 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $61.12 | $382.00 | $35.11 – $536.00 | 18 |
| Map tachycard site(s) CPT 93609 | $3,626.40 | $22,665.00 | $3,047.00 – $27,877.95 | 4 |
| Marker biop eviva buckle ss HCPCS A4648 | $178.08 | $1,113.00 | $665.43 – $665.43 | 1 |
| Mastoids complete CPT 70130 | $121.92 | $762.00 | $80.88 – $539.49 | 16 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $1,224.00 | $7,650.00 | $53.44 – $338.45 | 11 |
| M.avium-intra dna amp prob CPT 87561 | $34.77 | $217.32 | $35.09 – $366.43 | 16 |
| M.avium-intra dna dir prob CPT 87560 | $54.88 | $343.00 | $27.29 – $209.37 | 16 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $2.06 | $12.86 | $12.86 – $155.97 | 16 |
| Mayo aathr protein s free CPT 85306 | $2.18 | $13.62 | $13.62 – $165.42 | 16 |
| Mayo activated protein c resistance assay CPT 85307 | $3.84 | $24.00 | $13.62 – $165.27 | 16 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $33.68 | $210.50 | $38.57 – $147.47 | 14 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $15.45 | $96.59 | $14.69 – $111.88 | 4 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.