CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: St Elizabeth Edgewood

Billing Code: 94640 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$231

about 1.0× the $224 Medicare rate · typically $89–$237

modeled estimate · not a bill or quote

What this hospital charges insurers

$234

About the fair price

about $3 over the fair price · 1.0× Medicare

Medicare pays $224 Fair price $231 This hospital $234 Cash price $817 Hospital's list price $817

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

Highest price of the 9 KY hospitals we have prices for — worth calling around.

Cheapest $26 Priciest $234

Black dot = this hospital, among the 9 KY hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Breathing treatment (nebulizer) is about $231 (about 1.0× the $224 Medicare rate). St Elizabeth Edgewood charges insurers about $234, or about $817 in cash — about the fair price. Located in Edgewood, KY.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield AetnaCignaHumanaKaiser 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
UnitedHealthcaremajor	$221	99%
Blue Cross Blue Shieldmajor	$217	97%
Ambetter (Centene)	$434	194%
Devoted Health	$228	102%
WellCare	$234	105%
+ 1 smaller / regional plan	$482 - $536

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 817), 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 St Elizabeth Edgewood 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 St Elizabeth Edgewood

Compare: Breathing treatment (nebulizer) at other KY hospitals

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