CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Gunnison Valley Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $255
Cash Discount Price: $361
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Gunnison Valley Hospital is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $361. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.14x the Medicare baseline. Located in 711 N Taylor St, Gunnison, CO.

Cash / Self-Pay

$361

Average discount available for prompt cash payment at this facility.

Insurance Median

$255

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: $361 (161%)

Insurance Median: $255 (114%)

Cash: $361 (161% of Medicare)

Ins. Median: $255 (114% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicare (plans)	$22 - $208	10%
Gunnison County Coroner Op Only	$23 - $218	10%
Gunnison County Sheriff Op & Profee Only	$23 - $218	10%
Ebms Hdhp	$27 - $255	12%
Tetwp Op & Profee Only-All Plans	$27 - $255	12%
U Of Co Transplant-All Plans	$27 - $255	12%
Ebms Ppo Plan-All Other Plans	$32 - $298	14%
Gunnison County Employees-All Other Plans	$36 - $340	16%
Scottish Rites-All Plans	$36 - $340	16%
Elap Employers-All Plans	$38 - $361	17%
Blue Cross Blue Shield	$39 - $373	17%
Apostrophe-All Plans	$40 - $382	18%
Multiplan-All Plans	$42 - $395	19%
Aetna	$43 - $408	19%
Cofinity-All Plans	$43 - $408	19%
Rocky Mountain Health-All Plans	$43 - $404	19%
UnitedHealthcare	$43 - $404	19%
Cigna	$44 - $416	20%
Medicaid / KanCare	$79 - $248	35%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $361.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Gunnison Valley Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.