CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Northwest Medical Center Sahuarita

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $232
  • Cash Discount Price: $280
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Northwest Medical Center Sahuarita is $232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $280. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.04x the Medicare baseline. Located in 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ.
Cash / Self-Pay
$280

Average discount available for prompt cash payment at this facility.

Insurance Median
$232

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: $280 (125%)
Insurance Median: $232 (104%)
Cash: $280 (125% of Medicare)
Ins. Median: $232 (104% 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
Blue Cross Blue Shield $60 - $234 27%
Medicaid / KanCare $135 - $144 60%
Mercy Care $135 - $230 60%
UnitedHealthcare $148 - $235 66%
Self Pay $177 - $384 79%
Aetna $230 - $330 103%
Cigna $230 - $250 103%
Humana $230 103%
Medicare (plans) $230 103%
Node Caremore Mcr Adv $230 103%
Node Mercy Care Mcr Adv $230 103%
Department Of Veterans Affairs $234 105%
Node Champva $234 105%
Node Non Par Hospice Agree $234 105%
Node Triwest $234 - $250 105%
Node Va $234 105%
Tricare $234 105%
Node Clover Health Mcr Adv $236 105%
Node Devoted Health Mcr Adv $237 106%
Banner Mcr Adv $241 108%
Node Banner Mcr Adv $241 108%
Node Wellcare Mcr Adv $241 108%
Node Us Dept Of Labor $292 131%
Ambetter / Centene $329 147%
Node Health Choice Health Exchange $348 156%
Node Fusion Network $421 188%
Node J Allen Inmate Health Svcs $444 198%
Coventry Work Comp Al $590 264%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16260 South Rancho Sahuarita Boulevard, Sahuarita, AZ 85629
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals