CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Connecticut Childrens Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $422
Cash Discount Price: $299
vs. Medicare Baseline: 1.89x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Connecticut Childrens Medical Center is $422. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $299. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.89x the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$299

Average discount available for prompt cash payment at this facility.

Insurance Median

$422

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: $299 (134%)

Insurance Median: $422 (189%)

Cash: $299 (134% of Medicare)

Ins. Median: $422 (189% 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
Cigna	$324 - $441	145%
Great West Healthcare [100107]	$324 - $441	145%
Health Partners [110229]	$324 - $441	145%
Mvp Health Plan [100144]	$324 - $441	145%
Tufts Health Plan [100114]	$324 - $441	145%
Harvard Pilgrim [1001134]	$343 - $583	153%
Multiplan [1001126]	$343 - $543	153%
UnitedHealthcare	$343 - $583	153%
Blue Cross Blue Shield	$355 - $483	159%
Unicare [100148]	$355 - $483	159%
Wellpoint [100150]	$355 - $483	159%
Aetna	$356 - $537	159%
1199 National Benefit Fund [100134]	$395 - $537	177%
Government Employees Hospital Assoc [100115]	$395 - $537	177%
Humana	$395 - $537	177%
Meritain Health [100149]	$395 - $537	177%
Nippon Life Ins Co Of America [100112]	$395 - $537	177%
Yale Health Plan [100162]	$395 - $537	177%
Cdphp/Comm [100199]	$400 - $543	179%
Connecticare [100105]	$400 - $573	179%
Generic Multiplan [1001130]	$400 - $543	179%
Ultrabenefits/Comm [100181]	$400 - $543	179%
Emblem Health Commercial [1001108]	$422 - $573	189%
Medicaid / KanCare	$422 - $573	189%
Golden Rule [100106]	$583	261%
Oxford [100103]	$583	261%

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 $299.
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 Connecticut Childrens Medical Center 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.