CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Medstar Georgetown University Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $272
  • Cash Discount Price: $381
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Medstar Georgetown University Hospital is $272. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $381. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.22x the Medicare baseline. Located in 3800 Reservoir Rd, Washington, DC.
Cash / Self-Pay
$381

Average discount available for prompt cash payment at this facility.

Insurance Median
$272

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: $381 (170%)
Insurance Median: $272 (122%)
Cash: $381 (170% of Medicare)
Ins. Median: $272 (122% 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
Carefirst Blue Choice Inc $55 25%
Blue Cross Blue Shield $92 41%
Amerigroup $125 56%
Amerihealth Caritas District Of Columbia $125 56%
Hscsn $125 56%
Medstar Family Choice Inc $125 - $340 56%
UnitedHealthcare $164 - $1,087 73%
Carefirst Advantage Inc $259 116%
Tricare $259 116%
Aetna $266 - $375 119%
Health Care Service Corporation $272 122%
Humana $272 122%
Cigna $379 169%
Pfc $381 170%
Private Healthcare Systems (Phcs) $469 210%
First Health $498 223%
Beech Street $528 236%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3800 Reservoir Rd, Washington, DC 20007
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals