CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Adventist Health Reedley

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $23
  • Cash Discount Price: $9
  • vs. Medicare Baseline: 0.10x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Adventist Health Reedley is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.10x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.
Cash / Self-Pay
$9

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

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: $9 (4%)
Insurance Median: $23 (10%)
Cash: $9 (4% of Medicare)
Ins. Median: $23 (10% 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
Healthnet Medi-Cal $5 - $101 2%
Blue Shield Mcare $9 - $282 4%
Fhcn Pace Mcr Adv-All Plans $9 - $282 4%
Lasalle Med Assoc Profee Only - All Plans $9 4%
Tricare $9 - $282 4%
UnitedHealthcare $9 - $713 4%
Upn Mcr Adv Profee Only $9 4%
Ah Employee Health Plan - All Plans $10 - $507 4%
Community Care Ipa Mcal-All Plans $11 - $22 5%
Bc Mcal $12 - $25 5%
Cal Viva Hlth Mcal - All Plans $12 - $17 5%
Central Ca Alliance Mcal Profee Only $12 5%
Dignity Mcal Op/Profee Only-All Other Plans $12 - $18 5%
Medi-Cal $12 - $17 5%
Upn Mcal Profee Only-All Other Plans $12 5%
Kaiser - All Other Plans $13 - $336 6%
Kaiser Mcr Adv $13 - $282 6%
Western Growers/Pinnacle- All Plans $13 - $309 6%
Healthnet- All Other Plans $14 - $292 6%
Kern Health Systems Mcal-All Plans $15 - $17 7%
Aetna $17 - $465 8%
Blue Shield Epn - All Other Plans $17 - $364 8%
Central Ca Alliance Ccs Profee Only $18 8%
Central Ca Alliance Comm Profee Only - All Other P $18 8%
Blue Shield Non Epn $20 - $420 9%
Cigna $21 - $437 9%
Blue Cross Blue Shield $23 - $526 10%
Central Ca Alliance Chdp Profee Only $23 10%
Physicians Med Group Op/Profee Only- All Plans $26 - $538 12%
Dignity Mcr Adv Op/Profee Only $282 126%
Healthnet- Mcr Adv $282 126%
Phs Prime Health Srvcs $282 126%
Bright Health Mcr Adv - All Plans $442 198%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 372 W Cypress Ave, Reedley, CA 93654
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals