CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Alhambra Hospital Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $259
  • Cash Discount Price: $412
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Alhambra Hospital Medical Center is $259. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $412. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.16x the Medicare baseline. Located in 100 S Raymond Ave, Alhambra, CA.
Cash / Self-Pay
$412

Average discount available for prompt cash payment at this facility.

Insurance Median
$259

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: $412 (184%)
Insurance Median: $259 (116%)
Cash: $412 (184% of Medicare)
Ins. Median: $259 (116% 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
Ahmc-Reciprocity-Medi-Cal/Healthy Families $12 5%
Citrus Valley Health Partners $12 5%
La Care Pasc Seiu Misc $12 5%
La Care Medi-Cal Hmo $13 6%
Allied Physicians Of Ca Medi-Cal $17 8%
Health Net Medi-Cal $17 8%
Kaiser Medi-Cal $17 8%
Medi-Cal $17 8%
Miscellaneous Medi-Cal Hmo $17 8%
Blue Cross Blue Shield $19 - $420 8%
Ahmc-Reciprocity-Comm/Senior $78 - $171 35%
Allied Physicians Comm/Sr $91 - $200 41%
Allied Physicians Medi-Cal $91 - $200 41%
Wellcare Allied Senior Hmo $91 - $200 41%
Molina Health Plan $101 - $222 45%
Self Pay $104 - $228 46%
Medicare (plans) $143 - $342 64%
Aetna $148 - $325 66%
Kaiser Commercial $161 - $353 72%
Scan Senior Plan $168 - $370 75%
Stewart Mg Senior Hmo $169 76%
Multiplan $207 - $456 93%
Health Net Exchange Enhanced Ppo $229 102%
UnitedHealthcare $235 - $282 105%
Miscellaneous Commercial Ppo/Hmo $259 - $570 116%
Miscellaneous Work Comp Hmo $259 - $375 116%
Blue Shield 65 Plus $266 119%
Apa Aco $273 122%
Altamed Senior Services $277 124%
Brand New Day Sr $277 124%
Central Health Plan Of Ca Senior Hmo $277 124%
Health Net Senior Hmo $277 124%
Humana $282 126%
La Care Exchange $282 126%
Miscellaneous Senior Hmo $282 126%
Tricare $282 126%
Wellcare Senior Hmo $282 126%
Alignment Senior Hmo $291 130%
Cigna $339 - $570 152%
Health Net Salud Con Hmo $342 153%
Molina Exchange $346 155%
Health Net Exchange $347 155%
Blue Shield Value Network Exchange $389 174%
Ahmc Health $416 186%
Allied Physicians Of Ca Commercial $422 189%
Blue Shield Hmo/Ppo $433 194%
Health Net Ppo/Epo/Pos $587 262%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 S Raymond Ave, Alhambra, CA 91801
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals