CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Glenn Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $54
Cash Discount Price: $43
vs. Medicare Baseline: 0.24x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Glenn Medical Center is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.24x the Medicare baseline. Located in 1133 W Sycamore St, Willows, CA.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

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: $43 (19%)

Insurance Median: $54 (24%)

Cash: $43 (19% of Medicare)

Ins. Median: $54 (24% 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

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medi-Cal	$17	8%
UnitedHealthcare	$17 - $70	8%
Ca Health And Wellness - All Plans	$19	8%
Blue Cross Blue Shield	$34 - $271	15%
Humana	$34 - $268	15%
Blue Shield Exch	$46 - $71	21%
Cigna	$48 - $74	21%
First Health - All Plans	$48 - $74	21%
Healthnet - All Plans	$48 - $74	21%
Beech Street - All Plans	$51 - $78	23%
Blue Shield Ppo/Hmo - All Other Plans	$51 - $78	23%
Dept Of Corrections - All Plans	$51 - $78	23%
Galaxy Health Network - All Plans	$51 - $78	23%
Interplan - All Plans	$51 - $78	23%
Pacific Health Alliance - All Plans	$51 - $78	23%
Pponext - All Plans	$51 - $78	23%
Superior Ca Ppo - All Plans	$51 - $78	23%
Integrated Hp - All Plans	$53 - $81	24%
Health Mgmt Network - All Plans	$54 - $83	24%
Networks By Design - All Plans	$54 - $83	24%
Three Rivers - All Plans	$54 - $83	24%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $43.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Glenn Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.