CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Oroville Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $63
Cash Discount Price: $37
vs. Medicare Baseline: 0.28x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Oroville Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.28x the Medicare baseline. Located in 2767 Olive Highway, Oroville, CA.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$223.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $223.72 (100%)

Cash / Self-Pay: $37 (17%)

Insurance Median: $63 (28%)

Cash: $37 (17% of Medicare)

Ins. Median: $63 (28% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $223.72 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$11 - $242	5%
Butte County	$14 - $77	6%
Cigna	$32 - $176	14%
Coventry Health Care	$32 - $176	14%
Health Net	$32 - $176	14%
Multiplan	$32 - $176	14%
Interplan	$34 - $187	15%
Three Rivers Provider Network	$34 - $187	15%
UnitedHealthcare	$34 - $203	15%
Beech Street	$36 - $198	16%
Healthstar	$36 - $198	16%
Health Payors Organization	$38 - $209	17%
Blue Shield Of California	$39 - $213	17%
Blue Shield Value Network	$56	25%
Aetna	$203	91%
Community Care	$203	91%
Nivano Physicians Inc	$203	91%
River City Medical Group	$224	100%
Partnership Healthplan Of California	$335	150%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $37.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Oroville Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.