CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Children's Hospital Colorado

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $318
  • Cash Discount Price: $376
  • vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Children's Hospital Colorado is $318. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $376. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.42x the Medicare baseline. Located in 13123 E 16Th Ave, Aurora, CO.
Cash / Self-Pay
$376

Average discount available for prompt cash payment at this facility.

Insurance Median
$318

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: $376 (168%)
Insurance Median: $318 (142%)
Cash: $376 (168% of Medicare)
Ins. Median: $318 (142% 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
Denver Health Medical Plan $13 - $555 6%
Ccha Behavioral Health $33 - $74 15%
Integrated Health Plan $50 - $111 22%
Kaiser $113 - $540 51%
Rocky Mountain Health Plan Behavioral Health $132 - $296 59%
Carelon Behavioral Health $149 - $518 67%
Presbyterian Health Plan $159 - $422 71%
Colorado Access $162 - $363 72%
Colorado Access Behavioral Health $162 - $363 72%
Molina Healthcare Of Nebraska $182 - $407 81%
Molina Healthcare Of New Mexico $182 - $407 81%
Peak Health Alliance/Ebms $182 - $444 81%
Rocky Mountain Health Plan $182 - $481 81%
Healthy Blue Of Nebraska $192 - $429 86%
Humana $202 - $518 90%
UnitedHealthcare $206 - $496 92%
Evernorth Behavioral Health $215 - $481 96%
Interlink National $215 - $555 96%
Blue Cross Blue Shield $222 - $555 99%
Centivo $228 - $511 102%
Select Health $232 - $518 104%
Uchealth Plan Administrators $232 - $518 104%
Cigna $239 - $534 107%
Aetna $242 - $592 108%
Department Of Corrections $258 - $577 115%
Comppsych Behavioral Health $281 - $629 126%
First Choice Health $281 - $629 126%
Midlands Choice $281 - $629 126%
National Preferred Provider Network $281 - $629 126%
Multiplan $285 - $636 127%
Cofinity $298 - $666 133%
First Choice Of The Midwest $298 - $666 133%
Usa Managed Care Organization $298 - $666 133%
First Health Network $305 - $681 136%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13123 E 16Th Ave, Aurora, CO 80045
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens