CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Saint Agnes Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $279
  • Cash Discount Price: $170
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Saint Agnes Medical Center is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.25x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$170

Average discount available for prompt cash payment at this facility.

Insurance Median
$279

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: $170 (76%)
Insurance Median: $279 (125%)
Cash: $170 (76% of Medicare)
Ins. Median: $279 (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
Blue Cross Blue Shield $2 - $584 1%
Correctcare Integrated Health $2 1%
Medi-Cal Healthnet $2 1%
Blue Shield - Ca $67 - $358 30%
Aetna $77 - $276 34%
Meritain $86 38%
Trustmark Small Business Benefits $86 38%
Allied Benefit Systems $91 41%
Boon Chapman $91 41%
Hap $91 41%
Webtpa $91 41%
St Agnes Nicu Valley Childrens Hospital $170 76%
Healthnet $178 - $213 80%
Coventry $179 80%
Cba Network By Design $196 88%
Network Health $196 88%
Allegiance $202 90%
American Postal Workers Secondary $202 90%
Cigna $202 90%
Multiplan $220 98%
Phcs $220 98%
Interplan $236 105%
Humana $276 - $290 123%
UnitedHealthcare $282 - $644 126%
Medicare (plans) $288 - $290 129%
Welbe Health $290 130%
Align Senior Care $324 145%
Blue Benefit Administrators Of Massachusetts $358 160%
Blue Care Network $358 160%
Blue Distinction Transplant $358 160%
Blue Shield - Id (Regence) $358 160%
Blue Shield - Ny Highmark Northeastern $358 160%
Blue Shield - Ny Highmark Western $358 160%
Blue Shield - Pa (Highmark) $358 160%
Blue Shield - Wa (Regence) $358 160%
Kaiser Permanente $493 220%
Advantek Central Usd $584 261%
Geha $644 288%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals