CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Whittier Hospital Medical Center
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $424
- Cash Discount Price: $136
- vs. Medicare Baseline: 1.90x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Whittier Hospital Medical Center is $424. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.90x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
$136
Average discount available for prompt cash payment at this facility.
Insurance Median
$424
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: $136 (61%)
Insurance Median: $424 (190%)
Cash: $136 (61% of Medicare)
Ins. Median: $424 (190% 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 |
|---|---|---|
| Blue Cross Blue Shield | $1 - $1,212 | N/A |
| Capnet | $7 - $97 | 3% |
| Ahmc Medi-Cal Reciprocity Agreement | $12 | 5% |
| Aids Healthcare Foundation | $12 - $277 | 5% |
| Allied Physicians | $12 - $422 | 5% |
| Alta Med Health Network | $12 - $277 | 5% |
| Altamed Health Services Corporation | $12 | 5% |
| Applecare Medical Group | $12 | 5% |
| Beverly Hospital | $12 - $310 | 5% |
| Brand New Day | $12 - $346 | 5% |
| Emanate Health | $12 - $346 | 5% |
| Health Net | $12 - $1,450 | 5% |
| Healthy Way La | $12 | 5% |
| Heritage Provider Network | $12 - $380 | 5% |
| Kaiser Foundation | $12 - $1,697 | 5% |
| La Care Healthy Families/Healthy Kids | $12 | 5% |
| Non Contracted Medi-Cal | $12 | 5% |
| Prospect Health Plan | $12 - $451 | 5% |
| Synermed | $12 - $282 | 5% |
| La Care Health Plan | $13 - $1,333 | 6% |
| Caloptima | $16 - $277 | 7% |
| Monarch Healthplan | $16 | 7% |
| Avanti | $17 - $338 | 8% |
| Care First Health Plan | $17 | 8% |
| County Of Los Angeles Dept Of Health Services | $17 | 8% |
| Hollywood Presbyterian Adv Med Mcal | $17 | 8% |
| Hollywood Presbyterian Medpoint Mcal | $17 | 8% |
| Medi Caid/ Medi Cal | $17 | 8% |
| Pacific Independent Physician Association | $17 - $727 | 8% |
| Physician Healthways | $17 - $242 | 8% |
| Physicians Healthways Medical Corporation | $42 - $606 | 19% |
| Ahmc Reciprocity | $50 - $727 | 22% |
| Ahmc Reciprocity Agreement Senior/Commercial | $50 - $727 | 22% |
| Wear And Wood | $50 - $970 | 22% |
| Edward Medical Group | $59 - $848 | 26% |
| Molina Medical Center | $66 - $945 | 30% |
| Central Health Plan Of California | $67 - $970 | 30% |
| Allied Physicians Ipa | $76 - $1,091 | 34% |
| UnitedHealthcare | $80 - $2,109 | 36% |
| Blue Shield Of California | $84 - $1,212 | 38% |
| Aetna | $87 - $1,765 | 39% |
| Prospect Medical | $92 - $1,333 | 41% |
| Care 1St Health Plan | $101 - $1,454 | 45% |
| New Horizon Medical Group Inc | $101 - $1,454 | 45% |
| Cost Containment | $109 - $1,576 | 49% |
| Davita Healthcare Partners | $109 - $1,576 | 49% |
| Universal Care | $109 - $1,697 | 49% |
| Asi/Flex | $118 - $1,697 | 53% |
| Us Comp Care | $118 - $1,697 | 53% |
| Value Healthplan Of California | $118 - $1,600 | 53% |
| Community Care Network | $126 - $1,818 | 56% |
| Coventry Health Care | $126 - $1,818 | 56% |
| Coventry Health Care National Network | $126 - $1,818 | 56% |
| Fmc Los Angeles County | $126 - $1,818 | 56% |
| Interplan Corporation | $126 - $1,818 | 56% |
| Managed Care Administrators | $126 - $1,818 | 56% |
| Prohealth | $126 - $1,818 | 56% |
| Health Net Inc | $135 - $724 | 60% |
| Multiplan | $143 - $2,060 | 64% |
| Athens Administrators Ahmc Work Comp | $168 - $375 | 75% |
| Cigna | $168 - $525 | 75% |
| Commercial Non Contract | $168 - $2,424 | 75% |
| Interplan Health Group | $168 - $363 | 75% |
| Medi-Cal Sub Acute | $168 - $2,424 | 75% |
| Misc 1 | $168 - $375 | 75% |
| Multiplan Wc | $168 - $375 | 75% |
| One Legacy | $168 - $2,424 | 75% |
| Veterans Administration | $197 | 88% |
| Healthnet | $234 - $845 | 105% |
| Alta Los Angeles Hospitals Inc | $277 | 124% |
| Apa/Aco Inc | $277 | 124% |
| Central Health Plan | $277 | 124% |
| Easy Choice Health Plan | $277 | 124% |
| Humana | $277 | 124% |
| Medicare (plans) | $277 - $291 | 124% |
| Pacificare Of California | $277 | 124% |
| Scan Health Plan | $277 | 124% |
| Caremore | $282 | 126% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $282 | 126% |
| La Care Covered Direct | $282 | 126% |
| Pacific Alliance Medical Center | $282 | 126% |
| Private Pay | $282 | 126% |
| Self-Pay | $282 | 126% |
| Tricare | $282 | 126% |
| Alignment Health Plan | $291 | 130% |
| Molina Healthcare Of California | $291 | 130% |
| San Miguel Health Plan | $310 | 139% |
| Chinatown Service Center Pace | $338 | 151% |
| Ahmc Health | $352 | 157% |
| Knox-Keene Act | $352 | 157% |
| Great-West Healthcare Of California | $2,500 | 1117% |