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 |
|---|---|---|---|---|
| X-ray eye detection foreign body (both sides) CPT 70030 | $152.00 | $950.00 | $43.54 – $292.79 | 16 |
| X-ray facial bones complete > 3 views CPT 70150 | $220.16 | $1,376.00 | $65.77 – $539.49 | 16 |
| X-ray femur >=2 views (both sides) CPT 73552 | $281.60 | $1,760.00 | $38.00 – $292.79 | 16 |
| X-ray finger(s) >= 2 views (both sides) CPT 73140 | $182.88 | $1,143.00 | $27.51 – $292.79 | 16 |
| X-ray foot 2 views (both sides) CPT 73620 | $198.24 | $1,239.00 | $30.52 – $292.79 | 16 |
| X-ray forearm 2 views (both sides) CPT 73090 | $212.64 | $1,329.00 | $34.00 – $292.79 | 16 |
| X-ray hand 2 views (both sides) CPT 73120 | $228.96 | $1,431.00 | $30.52 – $539.49 | 16 |
| X-ray heel/calcaneus > 2 views (both sides) CPT 73650 | $196.32 | $1,227.00 | $33.56 – $292.79 | 16 |
| X-ray hip uni w/wo pelvis min 4 views CPT 73503 | $206.72 | $1,292.00 | $58.00 – $539.49 | 16 |
| X-ray hip with pelvis when performed bilateral 2 views CPT 73521 | $177.92 | $1,112.00 | $47.00 – $539.49 | 16 |
| X-ray hip with pelvis when performed bilateral 3-4 views CPT 73522 | $196.48 | $1,228.00 | $62.00 – $539.49 | 16 |
| X-ray hip with pelvis when performed bilateral >= 5 views CPT 73523 | $251.68 | $1,573.00 | $66.00 – $539.49 | 16 |
| X-ray hip with pelvis when performed unilateral 1 view left CPT 73501 | $119.20 | $745.00 | $46.77 – $292.79 | 16 |
| X-ray humerus >= 2 views left CPT 73060 | $235.04 | $1,469.00 | $34.00 – $292.79 | 16 |
| X-ray joint survey 1 view CPT 77077 | $773.76 | $4,836.00 | $58.63 – $539.49 | 16 |
| X-ray knee 1-2 views (both sides) CPT 73560 | $227.84 | $1,424.00 | $33.56 – $292.79 | 16 |
| X-ray knee 3 views (both sides) CPT 73562 | $242.72 | $1,517.00 | $40.00 – $292.79 | 16 |
| X-ray knee ap standing bilateral CPT 73565 | $99.20 | $620.00 | $33.56 – $292.79 | 16 |
| X-ray lower extremities infant > 2 views (both sides) CPT 73592 | $59.04 | $369.00 | $36.66 – $292.79 | 16 |
| X-ray l/s-spine bend vw only 2-3 vw CPT 72120 | $341.44 | $2,134.00 | $47.00 – $539.49 | 16 |
| X-ray lumbosacral spine >= 4 views CPT 72110 | $293.92 | $1,837.00 | $55.00 – $539.49 | 16 |
| X-ray lumbosacral spine complete including bending views >= 6 views CPT 72114 | $341.44 | $2,134.00 | $99.35 – $539.49 | 16 |
| X-ray mandible complete > 4 views CPT 70110 | $174.88 | $1,093.00 | $60.06 – $539.49 | 16 |
| X-ray mandible ltd <4 views CPT 70100 | $77.60 | $485.00 | $44.28 – $292.79 | 16 |
| X-ray nasal bones complete > 3 views CPT 70160 | $152.32 | $952.00 | $43.74 – $292.79 | 16 |
| X-ray neck soft tissue CPT 70360 | $146.40 | $915.00 | $30.52 – $292.79 | 16 |
| X-ray nose to rectum for foreign body child CPT 76010 | $60.80 | $380.00 | $41.18 – $292.79 | 16 |
| X-ray of mammary ducts CPT 77054 | $534.88 | $3,343.00 | $121.51 – $1,130.82 | 16 |
| X-ray pelvis 1-2 views CPT 72170 | $132.48 | $828.00 | $37.00 – $539.49 | 16 |
| X-ray pelvis complete > 3 views CPT 72190 | $138.88 | $868.00 | $55.66 – $539.49 | 16 |
| X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation CPT 74420 | $337.60 | $2,110.00 | $99.54 – $2,151.04 | 16 |
| X-ray ribs 2 views left CPT 71100 | $169.92 | $1,062.00 | $47.92 – $292.79 | 16 |
| X-ray ribs 3 views bilateral CPT 71110 | $209.44 | $1,309.00 | $58.77 – $539.49 | 16 |
| X-ray ribs w/posterior anterior chest 3 views left CPT 71101 | $176.32 | $1,102.00 | $57.02 – $539.49 | 16 |
| X-ray ribs w/posterior anterior chest > 4 views bilateral CPT 71111 | $244.16 | $1,526.00 | $74.81 – $539.49 | 16 |
| X-ray sacroiliac joints >= 3 views CPT 72202 | $115.36 | $721.00 | $52.17 – $539.49 | 16 |
| X-ray sacrum/coccyx >= 2 views CPT 72220 | $178.72 | $1,117.00 | $44.14 – $292.79 | 16 |
| X-ray scapula complete (both sides) CPT 73010 | $243.36 | $1,521.00 | $39.00 – $539.49 | 16 |
| X-ray sella turcica CPT 70240 | $160.32 | $1,002.00 | $38.14 – $292.79 | 16 |
| X-ray shoulder 1 view (both sides) CPT 73020 | $185.76 | $1,161.00 | $30.52 – $292.79 | 16 |
| X-ray sinuses paranasal complete > 3 views CPT 70220 | $154.08 | $963.00 | $58.84 – $292.79 | 16 |
| X-ray sinus tract/fistula/abscess CPT 76080 | $301.28 | $1,883.00 | $73.73 – $1,581.26 | 16 |
| X-ray skull < 4 views CPT 70250 | $200.64 | $1,254.00 | $45.84 – $539.49 | 16 |
| X-ray skull > 4 views complete CPT 70260 | $244.64 | $1,529.00 | $71.17 – $539.49 | 16 |
| X-ray slg plne bdy sect without urogr CPT 76100 | $242.40 | $1,515.00 | $100.76 – $539.49 | 16 |
| X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study CPT 74250 | $317.28 | $1,983.00 | $166.94 – $539.49 | 16 |
| X-ray small intestine follow-through study CPT 74248 | $231.52 | $1,447.00 | $89.53 – $393.02 | 12 |
| X-ray spine single view CPT 72020 | $132.00 | $825.00 | $30.52 – $292.79 | 16 |
| X-ray sternoclavicular joint(s) > 3 views CPT 71130 | $69.76 | $436.00 | $45.84 – $292.79 | 16 |
| X-ray sternum > 2 views CPT 71120 | $177.60 | $1,110.00 | $45.84 – $292.79 | 16 |
| X-ray surgical specimen CPT 76098 | $270.24 | $1,689.00 | $25.55 – $2,293.95 | 16 |
| X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study CPT 74230 | $342.40 | $2,140.00 | $91.59 – $539.49 | 16 |
| X-ray temporomandibular joint open/closed mouth bilateral CPT 70330 | $135.20 | $845.00 | $67.20 – $292.79 | 16 |
| X-ray thoracic spine 2 views CPT 72070 | $146.56 | $916.00 | $43.00 – $539.49 | 16 |
| X-ray thoracic spine 3 views CPT 72072 | $208.32 | $1,302.00 | $54.39 – $539.49 | 16 |
| X-ray thoracolumbar spine >=2 views CPT 72080 | $223.04 | $1,394.00 | $48.32 – $292.79 | 16 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 1 view CPT 72081 | $73.60 | $460.00 | $61.26 – $316.67 | 16 |
| X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views CPT 72082 | $157.60 | $985.00 | $99.35 – $578.71 | 16 |
| X-ray tibia/fibula 2 views (both sides) CPT 73590 | $266.88 | $1,668.00 | $34.00 – $292.79 | 16 |
| X-ray toe(s) > 2 views (both sides) CPT 73660 | $194.88 | $1,218.00 | $27.51 – $292.79 | 16 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast CPT 74246 | $305.28 | $1,908.00 | $203.34 – $1,191.26 | 16 |
| X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study CPT 74240 | $147.20 | $920.00 | $180.01 – $1,191.26 | 16 |
| X-ray wrist 2 views (both sides) CPT 73100 | $212.16 | $1,326.00 | $30.52 – $292.79 | 16 |
| X-ray xm phrnx&/crv esoph c+ CPT 74210 | $103.36 | $646.00 | $67.20 – $1,191.26 | 16 |
| Xtrnl ecg rec up to 48 hrs CPT 93224 | $53.28 | $333.00 | $80.79 – $1,764.60 | 13 |
| Yersinia antibody CPT 86793 | $1.88 | $11.72 | $11.72 – $142.32 | 16 |
| Zika virus dna/rna amp probe CPT 87662 | $7.30 | $45.61 | $45.61 – $510.93 | 16 |
| Zika virus igm antibody CPT 86794 | $2.40 | $14.97 | $14.97 – $167.81 | 16 |
| Ziprasidone 20 mg/ml (final concentration) intramuscular solution HCPCS J3486 | $49.50 | $309.35 | $24.92 – $380.50 | 6 |
| Zoledronic acid 4 mg/5 ml intravenous solution HCPCS J3489 | $66.00 | $412.50 | $13.83 – $589.51 | 6 |
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.