CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: City of Hope National Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $279
  • Cash Discount Price: $331
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at City of Hope National Medical Center is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $331. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.25x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.
Cash / Self-Pay
$331

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: $331 (148%)
Insurance Median: $279 (125%)
Cash: $331 (148% 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
Cal Optima $9 - $26 4%
Health Net $11 - $400 5%
Heritage Provider Network $11 - $239 5%
Inland Empire $11 - $273 5%
Prime Healthcare Keenan $16 - $328 7%
Blue Cross Blue Shield $159 - $345 71%
UnitedHealthcare $178 - $531 80%
Blue Shield $188 - $468 84%
Blue Shield Promise $222 - $239 99%
Blue Shield Covca $238 106%
Cencal $254 - $273 114%
La Care Health $254 - $273 114%
Kaiser $286 - $307 128%
Aetna $318 - $342 142%
Gold Coast $318 - $342 142%
Molina $318 - $444 142%
Cigna $341 - $367 152%
Facey $349 - $376 156%
Healthcare Partners $368 - $396 164%
St. Joseph Heritage $381 - $410 170%
Primecare Medical Network $413 - $444 185%
First Health $489 - $526 219%
Phcs Multiplan $572 - $615 256%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 Duarte Rd, Duarte, CA 91010
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL