CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Adventist Health Lodi Memorial

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $32
  • Cash Discount Price: $7
  • vs. Medicare Baseline: 0.14x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Adventist Health Lodi Memorial is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.14x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$7

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $7 (3%)
Insurance Median: $32 (14%)
Cash: $7 (3% of Medicare)
Ins. Median: $32 (14% 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
Alignment Health Plan (Ahp)-All Plans $9 - $289 4%
Blue Shield Mcare Adv $9 - $289 4%
Healthnet Mcare $9 - $289 4%
Hp Of San Joaquin Mcr Adv $9 - $289 4%
Humana $9 - $289 4%
Knnex Health - All Plans $9 - $347 4%
Tricare $9 - $289 4%
UnitedHealthcare $9 - $464 4%
Ah Employee Health Plan - All Plans $10 - $520 4%
Hp Healthy Kids Pro Fee $10 4%
First Health- All Plans $11 - $447 5%
Bc Mcal $12 - $25 5%
Beech Street- All Plans $12 - $490 5%
Celtic Ins Company - All Plans $12 - $19 5%
Hp Of San Joaquin Ppo - All Other Plans $12 - $518 5%
Kaiser Mcal $12 - $17 5%
Medi-Cal $12 - $17 5%
Multiplan- All Plans $12 - $436 5%
Hp Mcal Pro Fee $13 6%
Kaiser Commercial - All Other Plans $13 - $223 6%
Kaiser Mcr Adv $13 - $289 6%
Networks By Design- All Plans $13 - $272 6%
Western Growers- All Plans $13 - $435 6%
Healthnet Mcal $14 - $24 6%
Healthnet- All Other Plans $14 - $268 6%
Hp Of San Joaquin Mcal $14 - $21 6%
Blue Shield Epn - All Other Plans $19 - $177 8%
Blue Shield Non-Epn $20 - $183 9%
Cigna $22 - $490 10%
Blue Cross Blue Shield $23 - $499 10%
Aetna $24 - $222 11%
Medcore(Omni Ipa) Op Only- All Plans $25 - $142 11%
Three Rivers Provider Network- All Plans $86 - $490 38%
Cca Health Plan Mcr Adv- All Plans $289 129%
Bright Health - All Plans $578 258%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals