CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Kern Valley Healthcare District

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $55
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 0.25x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Kern Valley Healthcare District is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.25x the Medicare baseline. Located in 6412 Laurel Ave, Lake Isabella, CA.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $50 (22%)
Insurance Median: $55 (25%)
Cash: $50 (22% of Medicare)
Ins. Median: $55 (25% 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.

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
Healthnet (Aim) $17 - $21 8%
Healthnet Mcal $17 - $21 8%
Medi-Cal $17 8%
UnitedHealthcare $38 - $47 17%
Healthnet Med Adv $45 - $55 20%
Humana $45 - $55 20%
Brand New Day - All Plans $51 - $63 23%
Blue Shield - All Plans $68 30%
Tricare $149 - $184 67%
Blue Cross Blue Shield $157 70%
Aetna $161 - $200 72%
Healthnet- All Other Plans $168 - $208 75%
Cigna $181 - $224 81%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6412 Laurel Ave, Lake Isabella, CA 93240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals