CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Saint Alphonsus Regional Medical Center
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $238
- Cash Discount Price: $325
- vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Saint Alphonsus Regional Medical Center is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $325. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.06x the Medicare baseline. Located in 1055 North Curtis Road, Boise, ID.
Cash / Self-Pay
$325
Average discount available for prompt cash payment at this facility.
Insurance Median
$238
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: $325 (145%)
Insurance Median: $238 (106%)
Cash: $325 (145% of Medicare)
Ins. Median: $238 (106% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $6 - $113 | 3% |
| Blue Cross Blue Shield | $69 - $251 | 31% |
| Medicare (plans) | $69 - $244 | 31% |
| UnitedHealthcare | $69 - $264 | 31% |
| Aetna | $71 - $242 | 32% |
| American Health Advantage Of Idaho | $72 - $241 | 32% |
| Ada County Jail Inmate Ins | $79 | 35% |
| Centurion Of Idaho | $79 | 35% |
| Id County Ada | $79 | 35% |
| Id County Canyon | $79 | 35% |
| Id County Cat Fund | $79 | 35% |
| Id County Payette | $79 | 35% |
| Idaho Dept Health And Wellfare | $79 | 35% |
| Moda Health | $94 - $459 | 42% |
| Trillium Community Ohp | $113 | 51% |
| Mountain Health Co-Op | $158 | 71% |
| Pacificsource Health Plans | $158 - $193 | 71% |
| Selecthealth | $179 - $238 | 80% |
| Molina Marketplace | $191 - $558 | 85% |
| Blue Shield - Id (Regence) | $192 - $672 | 86% |
| Columbia Health Network | $193 | 86% |
| Allegiance | $195 | 87% |
| Employee Benefit Management | $224 | 100% |
| First Choice Health | $224 | 100% |
| Providence | $224 - $300 | 100% |
| Webtpa | $224 - $624 | 100% |
| Humana | $232 - $264 | 104% |
| Allied National Global Care | $238 | 106% |
| Asrm - Reliance Standard Life Insurance | $238 | 106% |
| Christian Care Ministry | $238 | 106% |
| Dean Health | $238 | 106% |
| Fallon Health | $238 | 106% |
| Family Life Insurance Company | $238 | 106% |
| First Health | $238 | 106% |
| Geha | $238 - $242 | 106% |
| Ghc Scw | $238 | 106% |
| Healthnet | $238 | 106% |
| International Benefit Administrators | $238 | 106% |
| Lifetime Benefit Solutions | $238 | 106% |
| Manhattan Life | $238 | 106% |
| Medi Share | $238 | 106% |
| Pai | $238 | 106% |
| Pan-American Life | $238 | 106% |
| Paramount Hmo | $238 | 106% |
| Phcs | $238 | 106% |
| Trinity Health Share | $238 | 106% |
| Allied Benefit Systems | $242 | 108% |
| Ameriben | $242 | 108% |
| Asr Health Benefits | $242 | 108% |
| Boon Chapman | $242 | 108% |
| Christian Brother Services | $242 | 108% |
| Healthez | $242 | 108% |
| Luminare Health (Detroit) | $242 | 108% |
| Meritain | $242 | 108% |
| Rural Carrier Health Benefit Plan | $242 | 108% |
| Bcn Domestic | $251 | 112% |
| Blue Benefit Administrators Of Massachusetts | $251 | 112% |
| Blue Care Network | $251 | 112% |
| Blue Distinction Transplant | $251 | 112% |
| Blue Shield - Ca | $251 | 112% |
| Blue Shield - Ny Highmark Northeastern | $251 | 112% |
| Blue Shield - Ny Highmark Western | $251 | 112% |
| Blue Shield - Pa (Highmark) | $251 | 112% |
| Blue Shield - Wa (Regence) | $251 - $672 | 112% |
| Health Choices | $251 | 112% |
| Kaiser Domestic | $251 | 112% |
| Pre-Employment | $251 | 112% |
| Wc Domestic | $251 | 112% |
| Cigna | $300 | 134% |
| Priority Health | $300 | 134% |
| Asuris Northwest Health | $672 | 300% |
| Healthcare Management Admin | $672 | 300% |