CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Sgmc Berrien Campus

Billing Code: 94640 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$149

about 0.7× the $224 Medicare rate · typically $46–$285

modeled estimate · not a bill or quote

Medicare pays $224 Fair price $149 Cash price $169 Hospital's list price $225

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

0 of 6 major insurers have a published price at this hospital

UnitedHealthcareBlue Cross Blue ShieldAetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
WellCare	$191	85%
+ 2 smaller / regional plans	$229 - $286

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 169), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 94640.

Insurance Before you use insurance

Call your insurance company to confirm Sgmc Berrien Campus is in-network.
Ask your insurer whether prior approval is required for CPT code 94640.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Sgmc Berrien Campus

Compare: Breathing treatment (nebulizer) at other GA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.