Los Robles Hospital & Medical Center
Los Robles Hospital & Medical Center in Thousand Oaks charges 14.2x the Medicare reimbursement rate across 143 analyzed procedures, with 90% showing significant price variations.
Thousand Oaks, CA 91360 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Billing patterns — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
F
Very high
Avg markup vs Medicare
14.16x
Charge / Medicare rate
Max markup
26.63x
Worst procedure
Procedures analyzed
143
With pricing data
Outlier procedures
90.2%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $123,235 | $61,618 | — | 26.6x |
| EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | 039 | $203,082 | $101,541 | — | 25.9x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $465,360 | $232,680 | — | 23.5x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | 282 | $113,736 | $56,868 | — | 23.1x |
| UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC | 743 | $200,762 | $100,381 | — | 21.5x |
| CERVICAL SPINAL FUSION WITHOUT CC/MCC | 473 | $448,811 | $224,406 | — | 20.6x |
| FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES | 748 | $232,981 | $116,490 | — | 20.3x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $146,615 | $73,308 | — | 20.2x |
| COMPLICATED PEPTIC ULCER WITH MCC | 380 | $303,519 | $151,759 | — | 19.3x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC | 455 | $793,515 | $396,757 | — | 18.9x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $131,148 | $65,574 | — | 18.9x |
| TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC | 086 | $209,399 | $104,699 | — | 18.7x |
| TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC | 087 | $111,477 | $55,739 | — | 18.6x |
| TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC | 082 | $323,268 | $161,634 | — | 18.1x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $232,510 | $116,255 | — | 17.9x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $199,044 | $99,522 | — | 17.9x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $353,873 | $176,937 | — | 17.6x |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | 441 | $318,508 | $159,254 | — | 17.5x |
| PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC | 273 | $598,018 | $299,009 | — | 17.5x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $103,105 | $51,552 | — | 17.3x |
| PERIPHERAL VASCULAR DISORDERS WITH MCC | 299 | $213,009 | $106,505 | — | 17.3x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $64,363 | $32,182 | — | 17.3x |
| MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | 483 | $320,833 | $160,416 | — | 16.9x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $141,665 | $70,832 | — | 16.9x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $118,717 | $59,359 | — | 16.7x |
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC | 494 | $258,022 | $129,011 | — | 16.6x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $170,810 | $85,405 | — | 16.6x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $146,384 | $73,192 | — | 16.5x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC | 454 | $910,742 | $455,371 | — | 16.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $1,071,687 | $535,843 | — | 16.4x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $261,054 | $130,527 | — | 16.4x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $291,829 | $145,914 | — | 16.4x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $277,329 | $138,665 | — | 16.2x |
| CERVICAL SPINAL FUSION WITH CC | 472 | $431,415 | $215,708 | — | 16.2x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $418,384 | $209,192 | — | 16.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $65,446 | $32,723 | — | 16.1x |
| PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC | 274 | $470,110 | $235,055 | — | 16x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $98,594 | $49,297 | — | 15.9x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $291,105 | $145,552 | — | 15.8x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $94,596 | $47,298 | — | 15.7x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $113,180 | $56,590 | — | 15.6x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $169,495 | $84,748 | — | 15.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $101,041 | $50,521 | — | 15.6x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $458,872 | $229,436 | — | 15.3x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | 482 | $205,981 | $102,991 | — | 15.2x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | 025 | $561,553 | $280,776 | — | 15.1x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $265,304 | $132,652 | — | 15x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $221,323 | $110,662 | — | 14.8x |
| SEIZURES WITHOUT MCC | 101 | $107,149 | $53,574 | — | 14.7x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $148,902 | $74,451 | — | 14.6x |
Showing 50 of 143 procedures
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use