CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: St Francis Hospital & Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $284
  • Cash Discount Price: $225
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at St Francis Hospital & Medical Center is $284. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.27x the Medicare baseline. Located in 114 Woodland Street & 500 Blue Hills Avenue, Hartford, CT.
Cash / Self-Pay
$225

Average discount available for prompt cash payment at this facility.

Insurance Median
$284

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: $225 (101%)
Insurance Median: $284 (127%)
Cash: $225 (101% of Medicare)
Ins. Median: $284 (127% 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
Allegiance $65 29%
Health Partners $65 29%
Cigna $65 - $327 29%
Magnacare $65 29%
Health New England $226 101%
Connecticare $238 - $284 106%
Aetna $242 - $303 108%
Connecticut Dept of Correction $242 108%
Medicare (plans) $257 - $270 115%
Blue Cross Blue Shield $257 - $912 115%
Cca Senior Care Options $262 117%
UnitedHealthcare $262 - $320 117%
Christian Care Ministry $278 124%
Pan-American Life $278 124%
Manhattan Life $278 124%
Paramount HMO $278 124%
Multiplan $278 124%
Mvp $278 124%
Family Life Insurance Company $278 124%
International Benefit Administrators $278 124%
Allied National Global Care $278 124%
Ghc Scw $278 124%
Trinity Health Share $278 124%
Asrm - Reliance Standard Life Insurance $278 124%
Dean Health $278 124%
PHCS $278 124%
Medi Share $278 124%
Pai $278 124%
Lifetime Benefit Solutions $278 124%
Prime Health Services $286 128%
Gravie Admin Services $303 135%
Meritain $303 135%
Webtpa $303 135%
1199 National Benefit Fund $303 135%
Luminare Health $303 135%
Nippon Life Ins $303 135%
Hap $303 135%
Allied Benefit Systems $303 135%
Geha $320 143%
Harvard Pilgrim Healthcare $320 143%
Fallon Health $341 152%
Health Smart $348 156%
Centivo $525 235%
Innovative Health Plan II $551 246%
Blue Shield - PA (Highmark) $912 408%
Pre-Employment $912 408%
Blue Shield - Ny Highmark Northeastern $912 408%
Blue Shield - Id (Regence) $912 408%
Blue Benefit Administrators of Massachusetts $912 408%
Unicare $912 408%
Blue Shield - Ca $912 408%
Blue Care Network $912 408%
Health Choices $912 408%
Bcn Domestic $912 408%
Wc Domestic $912 408%
Blue Shield - Wa (Regence) $912 408%
Blue Shield - Ny Highmark Western $912 408%
Blue Distinction Transplant $912 408%
Wellpoint $912 408%
Kaiser Domestic $912 408%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 114 Woodland Street & 500 Blue Hills Avenue, Hartford, CT 06105
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals