CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Adventist Health White Memorial
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $296
- Cash Discount Price: $187
- vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Adventist Health White Memorial is $296. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.32x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$187
Average discount available for prompt cash payment at this facility.
Insurance Median
$296
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: $187 (84%)
Insurance Median: $296 (132%)
Cash: $187 (84% of Medicare)
Ins. Median: $296 (132% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Access Medi-Cal | $17 | 8% |
| Ahp Medi-Cal | $17 | 8% |
| Alta Los Angeles Mcal 1/1/19 | $17 | 8% |
| Avanti Mcal | $17 | 8% |
| Bella Vista Medi-Cal Op/Profee Only | $17 | 8% |
| Healthcare Inc Medi-Cal | $17 | 8% |
| Lasalle Mg Medi-Cal | $17 | 8% |
| Medi-Cal | $17 | 8% |
| Molina Medi-Cal | $17 | 8% |
| Pacific Alliance Medi-Cal | $17 | 8% |
| Pacific Ipa Medi-Cal | $17 | 8% |
| Preferred Ipa La Care Mcal Cap | $17 | 8% |
| Preferred Medi-Cal | $17 | 8% |
| Altamed Medi-Cal - All Other Plans | $19 | 8% |
| Fcs Ipa Medi-Cal Op/Profee Only | $20 | 9% |
| Healthnet Mcal | $20 | 9% |
| Preferred Healthy | $21 | 9% |
| Assoc Hispanic Physcns Mcal | $24 | 11% |
| Bc Medi-Cal | $24 | 11% |
| Blue Shield Medi-Cal | $42 | 19% |
| Care First Medi-Cal | $59 | 26% |
| Blue Shield Mcr Adv | $105 | 47% |
| Access Group | $239 | 107% |
| Ahp - All Other Plans | $239 | 107% |
| Lasalle Mg Commercial - All Other Plans | $239 | 107% |
| Access Senior - All Other Plans | $282 | 126% |
| Ahp Senior | $282 | 126% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $282 | 126% |
| Altamed Connect | $282 | 126% |
| Avanti Mcr Adv - All Other Plans | $282 | 126% |
| Brand New Day Mcare - All Plans | $282 | 126% |
| Bs Va Mcare | $282 | 126% |
| Care First Mcare - All Other Plans | $282 | 126% |
| Clever Care - All Plans | $282 | 126% |
| Fcs Ipa Mcr Advan Op/Profee Only | $282 | 126% |
| Humana | $282 | 126% |
| Lasalle Mg Senior | $282 | 126% |
| Medicare (plans) | $282 | 126% |
| Molina Mcare | $282 | 126% |
| Pacific Alliance Mcare - All Other Plans | $282 | 126% |
| Preferred Senior | $282 | 126% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $282 | 126% |
| Tricare | $282 | 126% |
| UnitedHealthcare | $282 - $499 | 126% |
| Blue Cross Blue Shield | $293 - $549 | 131% |
| Fcs Ipa Op/Profee Only - All Other Plans | $296 | 132% |
| Bright Health - All Plans | $324 | 145% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $338 | 151% |
| Preferred Commercial - All Other Plans | $338 | 151% |
| Western Growers/Pinnacle - All Plans | $341 | 152% |
| Intergrated Medical - All Plans | $366 | 164% |
| Molina Benefit Exchange - All Other Plans | $380 | 170% |
| Pacific Ipa - All Other Plans | $395 | 177% |
| Php-Prospect Health Plan Cap - All Plans | $422 | 189% |
| Kaiser- All Plans | $426 | 190% |
| Cigna | $440 | 197% |
| Blue Shield Epn | $460 | 206% |
| Healthnet - All Other Plans | $470 | 210% |
| Healthnet Comm Care | $485 | 217% |
| Aetna | $505 | 226% |
| Ah Employee Health Plan - All Plans | $507 | 227% |
| Caremore Mcare - All Plans | $520 | 232% |
| Hcpamg - All Plans | $521 | 233% |
| Blue Shield - All Other Plans | $530 | 237% |
| Healthcare Inc - All Other Plans | $572 | 256% |
| La Care Mcr Adv - All Plans | $572 | 256% |
| First Heatlh Ppo - All Plans | $603 | 270% |
| Centivo - All Plans | $634 | 283% |
| Phcs Ppo - All Plans | $676 | 302% |
| Scan Health Mcare - All Plans | $676 | 302% |
| Ahf - All Plans | $780 | 349% |
| Beech Street - All Plans | $780 | 349% |
| Interplan Ppo - All Plans | $780 | 349% |
| Corvel Corp - All Plans | $832 | 372% |
| Multiplan Ppo - All Plans | $863 | 386% |
| Healthmannet - All Plans | $884 | 395% |
| Next Inc Ppo - All Plans | $884 | 395% |
| Trpn - All Plans | $884 | 395% |
| Bella Vista Mcr Adv Op/Profee Only - All Other Pla | $936 | 418% |
| Fpn Ppo - All Plans | $936 | 418% |
| Healthnet Mcr Adv | $1,591 | 711% |