CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Boston Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $270
  • Cash Discount Price: $248
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Boston Medical Center is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $248. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.21x the Medicare baseline. Located in 1 Boston Medical Center Place, Boston, MA.
Cash / Self-Pay
$248

Average discount available for prompt cash payment at this facility.

Insurance Median
$270

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: $248 (111%)
Insurance Median: $270 (121%)
Cash: $248 (111% of Medicare)
Ins. Median: $270 (121% 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
Workers Comp [5002] $16 7%
Zzzbu Employee Work Comp [5004] $16 7%
Zzzcity Of Boston Work Comp [5003] $16 7%
Unicare [8004] $35 16%
Wellpoint [2034] $35 16%
Medicaid / KanCare $199 89%
Uphams Corner Esp [1213] $221 99%
Champva [9004] $229 102%
Tricare $229 102%
Tufts [8002] $236 - $552 105%
Aetna $254 - $270 114%
Blue Cross Blue Shield $254 - $390 114%
Humana $254 114%
Medicare (plans) $254 - $267 114%
Neighborhood Pace [1206] $254 114%
Ubh Hphc [8016] $254 114%
UnitedHealthcare $254 - $625 114%
Veterans Admin [9003] $254 114%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010] $254 114%
Wellcare [1240] $265 118%
Cca [1215] $267 119%
Corrections [9001] $267 - $318 119%
Zzzcca Onecare [1216] $267 119%
Eternalhealth [1227] $270 121%
Meritain Health [1023] $270 121%
Fallon Sco [1126] $280 125%
Mass General Brigham Health Plan Commercial [8009] $298 133%
Senior Whole Health [1210] $305 136%
Fallon [8008] $331 148%
Tufts Conncare/Qhp [8020] $361 - $431 161%
Cigna $469 - $552 210%
Harvard Pilgrim Health Care [8001] $471 211%
Health Plans Inc [2027] $471 211%
United [2025] $471 - $625 211%
Zzzhealth Plans Inc [1013] $471 211%
Zzzunited [1008] $471 - $625 211%
Hsn Bad Debt [4003] $513 229%
Hsn Confidential [4007] $513 229%
Hsn Dental [4006] $513 229%
Hsn Partial [4002] $513 229%
Hsn [4001] $513 229%
Oxford Health [1007] $625 279%
Oxford Health [2024] $625 279%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Boston Medical Center Place, Boston, MA 02118
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals