CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Adventist Health and Rideout

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $243
  • Cash Discount Price: $63
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Adventist Health and Rideout is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.09x the Medicare baseline. Located in 726 4Th St, Marysville, CA.
Cash / Self-Pay
$63

Average discount available for prompt cash payment at this facility.

Insurance Median
$243

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: $63 (28%)
Insurance Median: $243 (109%)
Cash: $63 (28% of Medicare)
Ins. Median: $243 (109% 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
Kaiser Mcal $17 8%
Medi-Cal $17 8%
Bc Mcal $20 9%
Ca Health And Wellness- All Plans $21 9%
Celtic Mcaid-All Plans $21 9%
Healthnet Mcal $57 25%
Aetna $202 90%
Healthnet Comm-All Other Plans $207 93%
Kaiser-All Other Plans $217 97%
Blue Cross Blue Shield $219 - $285 98%
Blue Shield Uc Care Members $228 102%
UnitedHealthcare $230 - $283 103%
Cigna $243 109%
First Health-All Plans $249 111%
Phcs-All Plans $251 112%
Interplan-All Plans $256 114%
Blue Shield-All Other Plans $271 121%
Multiplan-All Plans $271 121%
Kaiser Mcr Adv $283 126%
Tricare $283 126%
Partnership Hp Mcal -All Plans $470 210%
Ah Employee Health Plan - All Plans $509 228%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 726 4Th St, Marysville, CA 95901
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Federal
  • Hospital Type: Acute Care Hospitals