CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Chinese Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $318
Cash Discount Price: $959
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Chinese Hospital is $318. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $959. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.42x the Medicare baseline. Located in 845 Jackson St, San Francisco, CA.

Cash / Self-Pay

$959

Average discount available for prompt cash payment at this facility.

Insurance Median

$318

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: $959 (429%)

Insurance Median: $318 (142%)

Cash: $959 (429% of Medicare)

Ins. Median: $318 (142% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$17 - $444	8%
Medi-Cal	$17	8%
San Francisco Health Plan- All Plans	$17	8%
Hp Of San Mateo Medi-Cal	$21	9%
Hp Of San Mateo Health Kids/Health Worx-All Other	$22	10%
Blue Shield Medi-Cal	$23	10%
Asian Medical Group Medi-Cal Op Only	$24	11%
Jade Medi-Cal	$30	13%
Blue Shield - All Other Plans	$96 - $279	43%
Aetna	$317 - $656	142%
Cchp Mcr Adv	$317	142%
Jade Mcr Adv	$317	142%
Jade-All Other Plans	$348	156%
On Lok Mcr Adv-All Plans	$348	156%
Health Net-All Plans	$408 - $609	182%
Cigna	$423 - $632	189%
Cchp-All Other Plans	$654 - $977	292%
Hp Of San Mateo Mcr Adv	$692 - $1,034	309%
Asian Medical Group Mcare Op Only-All Other Plans	$769 - $1,149	344%
Bay Area Accountable Care Mcare	$769 - $1,149	344%
Bay Area Accountable Care - All Other Plans	$1,384 - $2,068	619%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $959.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Chinese Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.