CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Flagstaff Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $246
  • Cash Discount Price: $223
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Flagstaff Medical Center is $246. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $223. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.10x the Medicare baseline. Located in 1200 North Beaver Street, Flagstaff, AZ.
Cash / Self-Pay
$223

Average discount available for prompt cash payment at this facility.

Insurance Median
$246

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: $223 (100%)
Insurance Median: $246 (110%)
Cash: $223 (100% of Medicare)
Ins. Median: $246 (110% 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
Health Choice $8 - $480 4%
University Of Arizona Health Plans $8 - $271 4%
Va Pccc Triwest $8 - $250 4%
Devoted $9 - $259 4%
Naphcare $15 - $501 7%
UnitedHealthcare $156 - $412 70%
Carefirst $182 81%
Mercy Care Rhba $182 81%
Ahcccs $188 84%
Ahcccs Other $188 84%
Fmc Jail $188 84%
Health Choice Arizona $188 84%
Health Choice Integrated Care $188 84%
Health Net Of Arizona $188 84%
Mercy Care $188 84%
Nhi Out Of State Ahcccs $188 84%
Self Pay $223 - $446 100%
Self-Pay 50% Discount $223 100%
Health Net Federal $234 105%
Aetna $246 - $379 110%
Fmc 30/70 $246 110%
Humana $246 - $423 110%
Medicare (plans) $246 110%
Mercy Care Advantage $246 110%
Rehabilitation Hospital Of Northern Arizona $246 110%
Snf Fmc $246 110%
Wellcare $246 110%
Wellcare By Allwell $246 110%
Fmc Ihs $250 112%
Blue Cross Blue Shield $261 - $327 117%
Ambetter / Centene $283 126%
Workers Comp $290 130%
Copperpoint $327 146%
Nau Athletic Department $357 160%
Pnoa $369 165%
Cigna $401 179%
Fmc 90/10 $401 179%
Rural Arizona Network Multiplan $401 179%
United Behavioral Health $446 199%
Auto Insurance $5,000 2235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 North Beaver Street, Flagstaff, AZ 86001
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals