CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: El Centro Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $280
  • Cash Discount Price: $230
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at El Centro Regional Medical Center is $280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $230. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.25x the Medicare baseline. Located in 1415 Ross Avenue, El Centro, CA.
Cash / Self-Pay
$230

Average discount available for prompt cash payment at this facility.

Insurance Median
$280

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: $230 (103%)
Insurance Median: $280 (125%)
Cash: $230 (103% of Medicare)
Ins. Median: $280 (125% 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.

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
Aetna $6 - $151 3%
UnitedHealthcare $7 - $281 3%
Pacificare-All Plans $8 - $213 4%
Mulitplan Primary - All Other Plans $9 - $234 4%
Cigna $10 - $258 4%
Multiplan Comp $11 - $275 5%
Trident - All Plans $11 - $292 5%
Healthnet Comm-All Other Plans $12 - $310 5%
Humana $12 - $320 5%
Ahccs/Medi-Cal Misc - All Plans $13 - $344 6%
Brand New Day Mcal $13 - $344 6%
Medi-Cal $13 - $344 6%
Molina Exchange - All Other Plans $13 - $344 6%
Ambetter / Centene $14 - $354 6%
Molina Mcal $15 - $378 7%
Blue Shield-All Plans $247 - $338 110%
Blue Cross Blue Shield $254 - $313 114%
Brand New Day Comm - All Other Plans $281 126%
Brand New Day Mcr $281 126%
Healthnet Mcr Adv $281 126%
Molina Mcr Adv $281 126%
Scp Managed Care - All Plans $281 126%
Tricare $281 126%
Easy Choice Mcr Adv-All Plans $309 138%
Healthnet Hmo $351 157%
Cdcr Correctional-All Plans $365 163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1415 Ross Avenue, El Centro, CA 92243
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals