CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Greater El Monte Community Hospital
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $81
- Cash Discount Price: $145
- vs. Medicare Baseline: 0.36x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Greater El Monte Community Hospital is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $145. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.36x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$145
Average discount available for prompt cash payment at this facility.
Insurance Median
$81
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: $145 (65%)
Insurance Median: $81 (36%)
Cash: $145 (65% of Medicare)
Ins. Median: $81 (36% 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 - $623 | N/A |
| Care 1St Medi Cal Hmo Cap Exceptional Care | $5 - $36 | 2% |
| Care First Health Plan | $5 - $36 | 2% |
| Clinica Medica Familiar | $6 - $180 | 3% |
| Bella Vista Medical Group Ipa | $10 - $162 | 4% |
| Global Care Medical Group Ipa | $10 - $162 | 4% |
| Ahmc Healthcare Inc | $12 | 5% |
| Aids Health Foundation | $12 - $277 | 5% |
| Allied Physicians Medical Group | $12 - $108 | 5% |
| Alta Med Health Services Med Grp | $12 - $90 | 5% |
| Altamed Health Network | $12 - $277 | 5% |
| Avanti | $12 - $338 | 5% |
| Beverly Hospital | $12 - $310 | 5% |
| Brand New Day | $12 - $352 | 5% |
| Emanate Health | $12 - $352 | 5% |
| Health Net Foundation | $12 - $645 | 5% |
| Healthy Way La | $12 | 5% |
| La Care Health Plan | $12 - $277 | 5% |
| Other Non Contracted Medi-Cal Hmo | $12 | 5% |
| State Of California | $12 | 5% |
| Ahmc Reciprocity Agreement | $14 - $108 | 6% |
| Ahmc Reciprocity Agreement Senior/Commercial | $14 - $108 | 6% |
| Good Samaritan Medical Practice Assoc | $14 - $282 | 6% |
| Lincoln Hospital Medical Center | $14 - $108 | 6% |
| Allied Physicians | $17 - $416 | 8% |
| Associated Hispanic Physicians | $17 - $253 | 8% |
| Caloptima | $17 | 8% |
| Hollywood Presbyterian Adv Med Mcal | $17 | 8% |
| Hollywood Presbyterian Medpoint Mcal | $17 | 8% |
| Molina Healthcare Of California | $19 - $352 | 8% |
| In Custody-Ca Highway Patrol | $20 | 9% |
| Blue Shield Of California | $24 - $433 | 11% |
| California Thoroughbred Horesmans Foundation | $24 - $180 | 11% |
| Universal Care | $24 - $253 | 11% |
| Care 1St Health Plan | $29 - $217 | 13% |
| Employee Health Systems Medical Group | $29 - $217 | 13% |
| Central Health Plan | $30 - $253 | 13% |
| Cost Containment Strategies | $31 - $235 | 14% |
| In Custody Police Dept | $31 - $235 | 14% |
| Interplan | $31 - $361 | 14% |
| UnitedHealthcare | $34 - $310 | 15% |
| Community Care Network | $38 - $289 | 17% |
| Multiplan | $41 - $361 | 18% |
| Pacificare Of California | $42 - $313 | 19% |
| Health Payors Organization | $43 - $325 | 19% |
| Athens Administrators | $48 - $361 | 21% |
| Cigna | $48 - $361 | 21% |
| Commercial Non Contract | $48 - $361 | 21% |
| Intercomp | $48 - $337 | 21% |
| Medi-Cal Sub Acute | $48 - $361 | 21% |
| Nuclear Medicine/Whmc | $48 - $361 | 21% |
| One Legacy | $48 - $361 | 21% |
| Other Non Contracted Work Comp | $48 - $361 | 21% |
| Preferred Health Network | $48 - $356 | 21% |
| Health Net Inc | $125 - $707 | 56% |
| Veterans Administration | $197 | 88% |
| Apa/Aco Inc | $277 | 124% |
| Cms | $277 | 124% |
| Easy Choice Health Plan | $277 | 124% |
| Other Non Contracted Senior Hmo | $277 | 124% |
| Pacific Alliance Medical Center Reciprocal Contract | $277 | 124% |
| Scan Health Plan | $277 | 124% |
| Champus Foundation | $282 | 126% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $282 | 126% |
| La Care Covered Direct | $282 | 126% |
| Self-Pay | $282 | 126% |
| Alignment Health Plan | $291 | 130% |
| Molina Healthcare | $291 | 130% |
| Inter Valley Health Plan | $296 | 132% |
| San Miguel Health Plan | $310 | 139% |
| Chinatown Service Center Pace | $333 | 149% |
| Ahmc Health Self-Insurance Epo | $352 | 157% |
| Knox-Keene Act | $352 | 157% |