CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: John Muir Medical Center - Concord Campus
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $317
- Cash Discount Price: $225
- vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at John Muir Medical Center - Concord Campus is $317. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.42x the Medicare baseline. Located in 2540 East St, Concord, CA.
Cash / Self-Pay
$225
Average discount available for prompt cash payment at this facility.
Insurance Median
$317
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: $225 (101%)
Insurance Median: $317 (142%)
Cash: $225 (101% of Medicare)
Ins. Median: $317 (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
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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 |
|---|---|---|
| Contra Costa County Jail [1012104] | $12 | 5% |
| Jmpn Canopy Hn [1640000011] | $15 | 7% |
| UnitedHealthcare | $15 - $578 | 7% |
| Carecentrix [1011001] | $200 - $396 | 89% |
| Generic Commercial/Indemnity [1017001] | $200 - $396 | 89% |
| Aps Healthcare [1003103] | $225 - $445 | 101% |
| United Behavioral Health [1048103] | $251 - $497 | 112% |
| Cigna | $253 - $708 | 113% |
| Carelon Behavioral Health [1050104] | $274 - $544 | 122% |
| Fortified Provider Network [1063104] | $274 - $544 | 122% |
| Medigap [1036001] | $274 - $544 | 122% |
| Three Rivers Provider Network [1073104] | $274 - $544 | 122% |
| Tricare | $283 | 126% |
| Health Net Hmo [1028103] | $285 - $564 | 127% |
| Health Net-Network [1028026] | $285 - $564 | 127% |
| Workers' Comp [1024005] | $289 | 129% |
| Contra Costa Health Plan Hmo [1013103] | $299 - $593 | 134% |
| Health Net-Network Mcare [1028127] | $303 | 135% |
| Aetna | $309 - $715 | 138% |
| Alignment Health [1177113] | $309 | 138% |
| Blue Cross Blue Shield | $309 - $643 | 138% |
| Blue Shield Hmo [1006103] | $309 - $628 | 138% |
| Blue Shield-Network Mcare [1006127] | $309 | 138% |
| Care 1St Health Plan [1094113] | $309 | 138% |
| Caremore [1171113] | $309 | 138% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] | $309 | 138% |
| Easy Choice Health Plan [1083113] | $309 | 138% |
| Essence Healthcare [1049028] | $309 | 138% |
| Essence Healthcare [1049128] | $309 | 138% |
| Golden State-Network Mcare [1023127] | $309 | 138% |
| Hospice Of East Bay [1085104] | $309 | 138% |
| Humana | $309 - $821 | 138% |
| Medicare (plans) | $309 - $791 | 138% |
| Scan-Network Mcare [1043127] | $309 | 138% |
| Veterans Administration [1051113] | $309 | 138% |
| Blue Shield-Network [1006026] | $317 - $628 | 142% |
| Blue Shield Ppo [1006104] | $332 - $728 | 148% |
| Western Health Advantage Hmo [1053103] | $349 - $791 | 156% |
| Health Net Ppo [1028104] | $362 - $718 | 162% |
| Kaiser Hmo [1033103] | $369 - $732 | 165% |
| Generic Hmo [1018103] | $387 | 173% |
| Generic Ppo [1021104] | $387 | 173% |
| Federal Correction Institute [1062104] | $399 - $791 | 178% |
| First Health [1016104] | $399 - $841 | 178% |
| Healthsmart - Pka Interplan [1031104] | $399 - $791 | 178% |
| Networks By Design [1084104] | $399 - $791 | 178% |
| Pponext [1072104] | $399 - $791 | 178% |
| Sutter Preferred Health Plan [1044104] | $399 - $791 | 178% |
| Brms [1091104] | $418 | 187% |
| Delta Health Systems [1032104] | $418 | 187% |
| Empire Plan [1092104] | $418 | 187% |
| Healthcomp [1089104] | $418 - $841 | 187% |
| Health Management Network [1066104] | $424 - $841 | 190% |
| Galaxy Health Network [1064104] | $449 - $890 | 201% |
| Integrated Health Plan [1075104] | $449 - $890 | 201% |
| Canopy Hn Hmo [1166103] | $566 | 253% |
| Donor Network West [1008103] | $12,000 | 5364% |