CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Northwest Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $235
  • Cash Discount Price: $295
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Northwest Medical Center is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $295. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.05x the Medicare baseline. Located in 6200 North La Cholla Boulevard, Tucson, AZ.
Cash / Self-Pay
$295

Average discount available for prompt cash payment at this facility.

Insurance Median
$235

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: $295 (132%)
Insurance Median: $235 (105%)
Cash: $295 (132% of Medicare)
Ins. Median: $235 (105% 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
Veterans Eval Services $8 4%
Blue Cross Blue Shield $60 - $234 27%
Medicaid / KanCare $135 - $144 60%
Magellan $142 - $241 63%
UnitedHealthcare $148 - $492 66%
Aetna $177 - $443 79%
Cigna $230 - $250 103%
Humana $230 103%
Medicare (plans) $230 103%
Node Caremore Mcr Adv $230 103%
Scan Health Plan $230 103%
Pascua Yaqui Tribe $231 103%
Department Of Veterans Affairs $234 105%
Node Non Par Hospice Agree $234 105%
Node Va $234 105%
Tricare $234 105%
Triwest $234 105%
Fresenius Health $235 105%
Node Clover Health Mcr Adv $236 105%
Self Pay $236 - $354 105%
Node Devoted Health Mcr Adv $237 106%
Node Banner Mcr Adv $241 108%
Wellcare $241 108%
Node Us Dept Of Labor $292 131%
Ambetter / Centene $329 147%
Node Health Choice Health Exchange $343 153%
Health Net $370 165%
Node Fusion Network $421 188%
Node J Allen Inmate Health Svcs $444 198%
First Health Coventry $517 231%
Seven Corners $537 240%
Coventry Medical Center $590 264%
Multiplan $817 365%
Prime Health $836 374%
Healthsmart $886 396%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6200 North La Cholla Boulevard, Tucson, AZ 85741
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals