CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Stanford Health Care

Billing Code: 94640 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$160

about 0.7× the $224 Medicare rate · typically $22–$457

modeled estimate · not a bill or quote

What this hospital charges insurers

$54

Below the fair price — a good deal

about $106 under the fair price · 0.2× Medicare

Medicare pays $224 Fair price $160 This hospital $54 Cash price $773 Hospital's list price $1,713

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $20 Priciest $54

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Breathing treatment (nebulizer) is about $160 (about 0.7× the $224 Medicare rate). Stanford Health Care charges insurers about $54, or about $773 in cash — below the fair price — a good deal. Located in Stanford, CA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Kaiser Permanente Humana

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$82	37%
Blue Cross Blue Shieldmajor	$54 - $69	24%
Aetnamajor	$67	30%
Cignamajor	$28 - $33	13%
Kaiser Permanentemajor	$24	11%
Health Net	$27 - $322	12%
+ 6 smaller / regional plans	$20 - $69

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 773), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 94640.

Insurance Before you use insurance

Call your insurance company to confirm Stanford Health Care is in-network.
Ask your insurer whether prior approval is required for CPT code 94640.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Stanford Health Care

Compare: Breathing treatment (nebulizer) at other CA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.