CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Johnson Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $167
  • Cash Discount Price: $992
  • vs. Medicare Baseline: 0.75x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Johnson Memorial Hospital is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $992. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.75x the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.
Cash / Self-Pay
$992

Average discount available for prompt cash payment at this facility.

Insurance Median
$167

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: $992 (443%)
Insurance Median: $167 (75%)
Cash: $992 (443% of Medicare)
Ins. Median: $167 (75% 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
Aetna $104 - $438 46%
Health New England $109 49%
Blue Cross Blue Shield $129 - $438 58%
1199 National Benefit Fund $130 58%
Allied Benefit Systems $130 58%
Cigna $130 - $452 58%
Gravie Admin Services $130 58%
Hap $130 58%
Luminare Health $130 58%
Meritain $130 58%
Nippon Life Ins $130 58%
Webtpa $130 58%
Prime Health Services $134 60%
Allied National Global Care $139 62%
Asrm - Reliance Standard Life Insurance $139 62%
Christian Care Ministry $139 62%
Dean Health $139 62%
Family Life Insurance Company $139 62%
Ghc Scw $139 62%
International Benefit Administrators $139 62%
Lifetime Benefit Solutions $139 62%
Manhattan Life $139 62%
Medi Share $139 62%
Multiplan $139 62%
Mvp $139 62%
Pai $139 62%
Pan-American Life $139 62%
Paramount Hmo $139 62%
Phcs $139 62%
Trinity Health Share $139 62%
Health Smart $142 63%
Connecticare $144 - $151 64%
Allegiance $152 68%
Health Partners $152 68%
Magnacare $152 68%
Bcn Domestic $167 75%
Blue Benefit Administrators Of Massachusetts $167 75%
Blue Care Network $167 75%
Blue Distinction Transplant $167 75%
Blue Shield - Ca $167 75%
Blue Shield - Id (Regence) $167 75%
Blue Shield - Ny Highmark Northeastern $167 75%
Blue Shield - Ny Highmark Western $167 75%
Blue Shield - Pa (Highmark) $167 75%
Blue Shield - Wa (Regence) $167 75%
Health Choices $167 75%
Kaiser Domestic $167 75%
Pre-Employment $167 75%
Unicare $167 75%
United Behavioral Health Eap $167 75%
UnitedHealthcare $167 - $438 75%
Wc Domestic $167 75%
Wellpoint $167 75%
Connecticut Dept Of Correction $242 - $413 108%
Medicare (plans) $257 - $461 115%
Cca Senior Care Options $262 - $447 117%
Fallon Health $341 - $582 152%
Geha $424 190%
Harvard Pilgrim Healthcare $424 190%
Claimdoc $551 - $939 246%
Diversified Administrators $551 - $939 246%
Innovative Health Plan Ii $551 - $939 246%
Centivo $612 - $1,042 274%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Chestnut Hill Road, Stafford Springs, CT 06076
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals