CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Monterey Park Hospital
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $196
- Cash Discount Price: $368
- vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Monterey Park Hospital is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $368. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.88x the Medicare baseline. Located in 900 S Atlantic Blvd, Monterey Park, CA.
Cash / Self-Pay
$368
Average discount available for prompt cash payment at this facility.
Insurance Median
$196
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: $368 (164%)
Insurance Median: $196 (88%)
Cash: $368 (164% of Medicare)
Ins. Median: $196 (88% 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 - $533 | N/A |
| Associated Hispanic Physicians Ancillary | $7 - $12 | 3% |
| Esperanza Medical Group Ipa | $7 - $12 | 3% |
| Access Ipa Ancillary | $9 - $12 | 4% |
| Accountable Ipa | $12 | 5% |
| Ahmc Healthcare Inc | $12 - $237 | 5% |
| Allied Physicians | $12 - $422 | 5% |
| Alta Med Health Services Corp | $12 - $277 | 5% |
| Altamed Health Network | $12 - $277 | 5% |
| Altamed Health Services | $12 | 5% |
| Applecare Medical Group | $12 - $225 | 5% |
| Assess Ipa | $12 | 5% |
| Beverly Hospital | $12 - $310 | 5% |
| Brand New Day | $12 - $352 | 5% |
| Care 1St Mcl/Gar Cap | $12 | 5% |
| Community Health Plan | $12 | 5% |
| Family Health Alliance Medical Group | $12 - $237 | 5% |
| Health Net Medi Cal | $12 | 5% |
| Healthnet Inc | $12 | 5% |
| Healthy Way La | $12 | 5% |
| La Care | $12 - $282 | 5% |
| La Care Health Plan | $12 - $434 | 5% |
| Medical Managed Care Program | $12 | 5% |
| Molina Healthcare | $12 | 5% |
| Other Non-Contracted Medi-Cal | $12 | 5% |
| Preferred Ipa | $12 - $352 | 5% |
| Preferred Ipa Of California | $12 | 5% |
| Alhambra Community Dialysis Unit Inc | $15 - $474 | 7% |
| Aids Health Foundation | $17 - $277 | 8% |
| Avanti | $17 - $338 | 8% |
| Bella Vista Medical Group Ancillary | $17 | 8% |
| Central Health Plan | $17 | 8% |
| Emanate Health | $17 - $352 | 8% |
| Hollywood Presbyterian Adv Med Mcal | $17 | 8% |
| Hollywood Presbyterian Medpoint Mcal | $17 | 8% |
| Maxi Med Inc/Ipa | $17 - $282 | 8% |
| Medi Cal | $17 | 8% |
| Pacific Independent Physician Association | $17 - $237 | 8% |
| Altamed Health Services Corporation | $20 - $79 | 9% |
| Care 1St M Cal | $20 - $79 | 9% |
| Crown City Medical Group Inc | $20 - $79 | 9% |
| Garfield Medical Center | $20 - $79 | 9% |
| Physician Healthways | $20 - $198 | 9% |
| Universal Care M Cal/Advantage Health Network | $20 - $79 | 9% |
| Caloptima Direct | $25 | 11% |
| Global Care Medical Group Ipa | $39 - $356 | 17% |
| Healthnet/Ehs Capitation | $39 - $158 | 17% |
| Hispanic Physicians Ipa Medical Corporation | $49 - $198 | 22% |
| Ahmc Reciprocity Agreement Senior/Commercial | $59 - $237 | 26% |
| Allied Physicians Ipa | $59 - $237 | 26% |
| Bella Vista Medical Group | $59 - $237 | 26% |
| Community Health Plan M Cal Joy Ipa | $59 - $237 | 26% |
| Tenet Reciprocity | $59 - $237 | 26% |
| Healthcare Partners Affiliates Medical Group | $70 - $282 | 31% |
| Molina Medical Centers | $76 - $308 | 34% |
| Central Health Plan Of California | $78 - $316 | 35% |
| Blue Shield Of California | $98 - $433 | 44% |
| Aetna | $104 - $575 | 46% |
| Health Net Of California | $117 - $839 | 52% |
| Care 1St Health Plan | $118 - $474 | 53% |
| Employee Health Systems Medical Group | $118 - $474 | 53% |
| Greater Los Angeles Dialysis Inc | $118 - $474 | 53% |
| One Health Plan | $118 - $775 | 53% |
| Choice Care Network | $127 - $514 | 57% |
| Healthnet | $127 - $514 | 57% |
| Health Net | $135 - $277 | 60% |
| UnitedHealthcare | $137 - $553 | 61% |
| Universal Care | $137 - $553 | 61% |
| Interplan | $147 - $592 | 66% |
| Corvel Corporation | $157 - $925 | 70% |
| Preferred Health Network | $157 - $632 | 70% |
| Bce Emergis Corp | $167 - $672 | 75% |
| Multiplan | $167 - $672 | 75% |
| Asi Flex Ppo W/C | $196 - $341 | 88% |
| Athens Administrators | $196 - $341 | 88% |
| Commercial Non Contract | $196 - $790 | 88% |
| Indemnity W Comp Fee Schedule | $196 - $341 | 88% |
| Mri/Ct Greater El Monte Hospital | $196 - $790 | 88% |
| Mri/Mra/Alhambra Hospital | $196 - $790 | 88% |
| Mri/Mra/Eladh | $196 - $790 | 88% |
| One Legacy | $196 - $790 | 88% |
| Veterans Administration | $197 | 88% |
| Pacificare | $219 - $263 | 98% |
| Health Net Inc | $234 - $987 | 105% |
| Senior Citizens Choice | $250 | 112% |
| Alignment Health Plan | $273 | 122% |
| Apa/Aco Inc | $277 | 124% |
| Cms | $277 | 124% |
| Easy Choice Health Plan | $277 | 124% |
| First Health Senior | $277 | 124% |
| Foundation Health Plan | $277 | 124% |
| Humana | $277 | 124% |
| Medicare (plans) | $277 - $291 | 124% |
| Scan Health Plan | $277 | 124% |
| Secure Horizons | $277 | 124% |
| Ucla/Impact Cancer | $277 | 124% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $282 | 126% |
| La Care Covered Direct | $282 | 126% |
| Self-Pay | $282 | 126% |
| Molina Healthcare Medi-Connect | $291 | 130% |
| San Miguel Health Plan | $310 | 139% |
| Ahmc Health Epo | $352 | 157% |
| Knox-Keene Act | $352 | 157% |
| Molina Healthcare Of California | $352 | 157% |
| Cigna | $525 | 235% |