CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $367
  • Cash Discount Price: $818
  • vs. Medicare Baseline: 1.64x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Healthone Presbyterian St Luke's is $367. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $818. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.64x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.
Cash / Self-Pay
$818

Average discount available for prompt cash payment at this facility.

Insurance Median
$367

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: $818 (366%)
Insurance Median: $367 (164%)
Cash: $818 (366% of Medicare)
Ins. Median: $367 (164% 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
Vail Health $116 - $132 52%
Kaiser $153 - $227 68%
United $158 - $392 71%
Cigna $194 - $558 87%
Aetna $229 - $460 102%
Bright Health $229 - $261 102%
Pinnacol Workers Comp $328 147%
Multiplan $342 - $784 153%
Emerging Therapy Solutions $367 - $558 164%
Kaiser National Transplant $367 - $418 164%
Colorado Program For Children With Special Needs $390 - $444 174%
Western Plains Community Health $497 - $566 222%
Northcare $535 - $610 239%
Physician Health Partners $535 - $610 239%
Blue Cross Blue Shield $566 - $645 253%
Medical Development International $611 - $697 273%
Prime Health $688 - $784 308%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1719 E 19Th Ave, Denver, CO 80218
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals