CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Scripps Green Hospital
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $132
- Cash Discount Price: $95
- vs. Medicare Baseline: 0.59x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Scripps Green Hospital is $132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.59x the Medicare baseline. Located in 10666 North Torrey Pines Road, La Jolla, CA.
Cash / Self-Pay
$95
Average discount available for prompt cash payment at this facility.
Insurance Median
$132
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: $95 (42%)
Insurance Median: $132 (59%)
Cash: $95 (42% of Medicare)
Ins. Median: $132 (59% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $10 - $282 | 4% |
| UnitedHealthcare | $10 - $296 | 4% |
| Radys Cpmg [803] | $20 - $31 | 9% |
| Blue Cross Blue Shield | $45 - $282 | 20% |
| Cigna | $45 - $282 | 20% |
| Mc Alignment [917] | $45 - $70 | 20% |
| Mc Blue Shield Promise Health Plan [914] | $45 - $70 | 20% |
| Mc Blue Shield [902] | $45 - $70 | 20% |
| Mc Health Net [904] | $45 - $70 | 20% |
| Mc Scan [905] | $45 - $70 | 20% |
| Mc United [906] | $45 - $70 | 20% |
| Bc [814] | $55 - $86 | 25% |
| Imperial County Phys Med Group [855] | $55 - $133 | 25% |
| Integrated Health Partners [894] | $55 - $86 | 25% |
| Perlman Med Group [899] | $55 - $86 | 25% |
| Sharp Comm Med Grp [812] | $55 - $177 | 25% |
| Sharp Rees Stealy Med Grp [811] | $55 - $177 | 25% |
| Ucsd [807] | $55 - $177 | 25% |
| Centivo [581] | $57 - $90 | 25% |
| Blue Shield [230] | $82 - $140 | 37% |
| Health Net [340] | $84 - $704 | 38% |
| Hn [815] | $84 - $131 | 38% |
| Bs [816] | $85 - $138 | 38% |
| Uh [819] | $87 - $136 | 39% |
| Rady Children'S Hospital [825] | $102 - $160 | 46% |
| Palomar Health [892] | $113 - $177 | 51% |
| Veba Med Grp [813] | $113 - $177 | 51% |
| Kaiser Northern Ca Region Hmo/Ppo [384] | $136 - $212 | 61% |
| Kaiser [380] | $136 - $212 | 61% |
| Kaiser [383] | $136 - $212 | 61% |
| Multi Plan Network [470] | $177 - $277 | 79% |
| First Health Network [330] | $187 - $292 | 84% |
| Pnoa [615] | $187 - $292 | 84% |
| Choice Care Network [270] | $200 - $312 | 89% |
| Healthsmart [350] | $200 - $312 | 89% |
| Astiva Mcr Adv [464] | $282 | 126% |
| Bc Mcr Adv [830] | $282 | 126% |
| Bs Mcr Adv [829] | $282 | 126% |
| Central Health Mcr Adv [441] | $282 | 126% |
| Clever Care Mcr Adv [465] | $282 | 126% |
| D-Snp Mcr Adv [889] | $282 | 126% |
| Dsnp/Csnp - Generic [458] | $282 | 126% |
| Family Health Centers Pace Mcr Adv Hmo [556] | $282 | 126% |
| Family Health Centers Pace Medi-Cal [555] | $282 | 126% |
| Gary And Mary West Pace Medi-Cal Hmo [557] | $282 | 126% |
| Gpmg/Altura - Mcr Adv [888] | $282 | 126% |
| Hn Mcr Adv [832] | $282 | 126% |
| Humana | $282 | 126% |
| Integrated Health Partners - Mcr Adv [895] | $282 | 126% |
| Kaiser Northern Ca Region Mcr Adv [386] | $282 | 126% |
| La Care Mcr Adv Hmo [612] | $282 | 126% |
| Medicare (plans) | $282 | 126% |
| Mpmg Mcr Adv [836] | $282 | 126% |
| Mpmg [800] | $282 | 126% |
| Ocn Mcr Adv [890] | $282 | 126% |
| San Diego Pace Medi-Cal [553] | $282 | 126% |
| Scan Mcr Adv [835] | $282 | 126% |
| Scan [500] | $282 | 126% |
| Scan [818] | $282 | 126% |
| Sharp Comm Med Grp Mcr Adv [840] | $282 | 126% |
| Sharp Health Plan Mcr Adv [531] | $282 | 126% |
| Sharp Health Plan Mcr Adv [897] | $282 | 126% |
| Sharp Rees Stealy Med Grp Mcr Adv [841] | $282 | 126% |
| St Paul'S Pace Medi-Cal [551] | $282 | 126% |
| Ucsd Mcr Adv [873] | $282 | 126% |
| Uh Mcr Adv [831] | $282 | 126% |
| Uh Palomar Health Mcr Adv [885] | $282 | 126% |
| Alignment Health Plan [443] | $290 | 130% |
| Prime Healthcare [614] | $479 | 214% |
| Prospect Med Group [893] | $493 | 220% |