CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Coastal Communities Hospital
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $315
- Cash Discount Price: $870
- vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Coastal Communities Hospital is $315. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $870. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.41x the Medicare baseline. Located in 2701 S Bristol St, Santa Ana, CA.
Cash / Self-Pay
$870
Average discount available for prompt cash payment at this facility.
Insurance Median
$315
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: $870 (389%)
Insurance Median: $315 (141%)
Cash: $870 (389% of Medicare)
Ins. Median: $315 (141% 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 |
|---|---|---|
| Kpc Healthcare Inc | $14 - $352 | 6% |
| Altamed Mcal Hmo (Ancillary) | $17 | 8% |
| Healthcare Partners | $17 | 8% |
| Hollywood Presbyterian | $17 - $280 | 8% |
| Kaiser | $17 - $536 | 8% |
| Medi-Cal Hmo/Non Contract | $17 | 8% |
| Medicaid / KanCare | $17 | 8% |
| Altamed Health Services | $23 - $280 | 10% |
| Caloptima | $23 - $282 | 10% |
| Choc Health Alliance | $23 | 10% |
| County Of Orange | $23 | 10% |
| Family Choice | $23 | 10% |
| Heritage Provider Network | $23 - $522 | 10% |
| Prospect Health Plan | $23 - $422 | 10% |
| Ihhi Reciprocity | $85 | 38% |
| Monarch | $203 - $280 | 91% |
| Monarch Health Plan | $255 | 114% |
| Champus | $270 | 121% |
| Blue Shield | $280 - $1,068 | 125% |
| Central Health Plan Of California | $280 | 125% |
| Champion Health Plan | $280 | 125% |
| Citizens Choice Health Plan | $280 | 125% |
| Clever Care Health Plan | $280 | 125% |
| Easy Choice Health Plan | $280 | 125% |
| For Your Benefit | $280 | 125% |
| Health Net | $280 - $635 | 125% |
| Healthcare Partners Sr Hmo | $280 | 125% |
| Heritage | $280 | 125% |
| Humana | $280 | 125% |
| Onecare | $280 | 125% |
| Onecare Connect | $280 | 125% |
| Other Senior Non Contract | $280 | 125% |
| Scan Health Plan | $280 | 125% |
| UnitedHealthcare | $280 - $434 | 125% |
| Us Federal Marshall/Department Of Immigration | $280 | 125% |
| Velocity Provider Network Sr | $280 | 125% |
| Verda Health Plan Sr | $280 | 125% |
| Veterans Administration | $280 | 125% |
| Choice Physicians Network | $282 | 126% |
| Imperial Health Plan Of Ca | $282 | 126% |
| Innovative Integrated Health | $282 | 126% |
| Medcare Partners | $282 | 126% |
| Self Pay Ab774/Cbo Use Only | $282 | 126% |
| Us Dept Of Labor | $282 | 126% |
| Victim Of Violent Crime | $282 | 126% |
| Victoria Hospice | $282 | 126% |
| Brand New Day | $314 | 140% |
| Cigna | $315 - $566 | 141% |
| Prime Health Srvs | $322 - $696 | 144% |
| Coventry Auto Network | $337 | 151% |
| Prime Health Srvs/Wc | $337 | 151% |
| Interplan | $341 - $652 | 152% |
| County Of Orange/Custody/Advanced Medmgt | $350 | 156% |
| Coventry Wc | $350 | 156% |
| Veterans Evaluation Services | $352 | 157% |
| Multiplan | $367 - $609 | 164% |
| Three Rivers | $367 | 164% |
| Velocity National Provider Network Wc | $375 | 168% |
| Workers Comp State Of California | $375 | 168% |
| Staywell/Island Home Ins | $394 | 176% |
| First Health | $457 | 204% |
| Aetna | $476 | 213% |
| Three Rivers Network | $493 | 220% |
| Velocity National Provider Network Ppo | $493 | 220% |
| Magellan | $522 | 233% |
| Networks By Design | $609 | 272% |
| Networks By Design Wc | $609 | 272% |
| Healthsmart | $652 | 291% |
| Prime Health | $652 | 291% |
| Pnoa-Provider Network Of America | $696 | 311% |
| Prime Health Srvs/Network | $740 | 331% |
| Lucet Behavioral Health Sr | $870 | 389% |
| Managed Health Network | $870 | 389% |
| Other Insurance Loa | $870 | 389% |
| Other Non Contracted Plans | $870 | 389% |
| Private Pay | $870 | 389% |
| Us Behavioral Health Plan | $870 | 389% |
| Vitas Hospice | $870 | 389% |