CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Ventura County Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $151
  • Cash Discount Price: $103
  • vs. Medicare Baseline: 0.67x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Ventura County Medical Center is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.67x the Medicare baseline. Located in 300 Hillmont Avenue, Ventura, CA.
Cash / Self-Pay
$103

Average discount available for prompt cash payment at this facility.

Insurance Median
$151

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: $103 (46%)
Insurance Median: $151 (67%)
Cash: $103 (46% of Medicare)
Ins. Median: $151 (67% 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
Hpn Ip/Op Only Medi-Cal $17 8%
Kaiser Medi-Cal Ip/Op Only $17 8%
Medi-Cal $17 8%
Kaiser Mcal Pediatric Ip/Op Only $18 8%
Clinicas Mcal $21 9%
Americas Hp Mcal Ip/Op Only $22 10%
Vchcp-All Plans $28 - $51 13%
Gold Coast Medi-Cal-All Plans $30 13%
Blue Shield Epn $57 - $103 25%
UnitedHealthcare $80 - $290 36%
Healthnet Comm-All Other Plans $81 - $146 36%
Kaiser Comm Pediatric Ip/Op Only $81 - $146 36%
Aetna $85 - $266 38%
Multiplan/Claritev-All Plans $118 - $213 53%
Three Rivers Ip/Op Only-All Plans $118 - $213 53%
Ppo Next Ip/Op Only-All Plans $132 - $239 59%
Kaiser Mcr Pediatric Ip/Op Only $147 - $266 66%
Medicare (plans) $147 - $266 66%
Cigna $148 66%
Blue Shield Comm - All Other Plans $172 77%
Hpn Comm Ip/Op Only-All Other Plans $209 - $378 93%
Blue Cross Blue Shield $234 105%
Tricare $273 122%
Alignment Hp - All Plans $282 126%
Blue Shield Mcr Adv $282 126%
Humana $282 126%
Healthnet Mcr Adv $296 132%
Clinicas Mcr Adv $321 143%
Americas Hp Mcr Adv Ip/Op Only $324 145%
Scan-All Plans $338 151%
Western Growers-All Plans $352 157%
Clinicas Comm - All Other Plans $366 164%
Imperial-All Plans $366 164%
Ntwrk Provdrs-All Plans $366 164%
Americas Hp Comm Ip/Op Only-All Other Plans $422 189%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Hillmont Avenue, Ventura, CA 93003
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals