CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: North Adams Regional Hospital Corporation

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $71
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 0.32x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at North Adams Regional Hospital Corporation is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.32x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$71

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: $94 (42%)
Insurance Median: $71 (32%)
Cash: $94 (42% of Medicare)
Ins. Median: $71 (32% 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
Mcd Masshealth $7 - $298 3%
Mcd New York $7 - $147 3%
Mcd Out Of State $7 - $298 3%
Mcdmanaged Cdphp $7 - $298 3%
Mcdmanaged Hne Mcdaco $7 - $298 3%
Medicaid / KanCare $7 - $360 3%
Comm Network Qhpsub $8 - $462 4%
Mcdmanaged Bmchnp $8 - $310 4%
Mcdmanaged Network $8 - $462 4%
Tricare $8 - $308 4%
Comm Hospice $9 - $188 4%
Mcr Miscellaneous $9 - $188 4%
Mcrmanaged Usa Family $9 - $188 4%
Mcrmanaged Va $9 - $188 4%
Medicare (plans) $9 - $190 4%
Oth United Vaccn $9 - $188 4%
Blue Cross Blue Shield $10 - $695 4%
Mcrmanaged Cca One Care $10 - $186 4%
Aetna $11 - $618 5%
Comm Fallon Qhp $12 - $463 5%
Wc Workers Comp $16 - $496 7%
Comm Hne Hmo $17 - $564 8%
Comm Hne $18 - $597 8%
Comm Hne Ppo $18 - $599 8%
Comm Network Qhpnonsub $39 - $588 17%
Comm Nhp $39 - $529 17%
Comm Unicare $40 - $530 18%
Comm Tufts $48 - $648 21%
UnitedHealthcare $52 - $703 23%
Cigna $55 - $761 25%
Comm Cdphp $55 - $736 25%
Comm Mvp $55 - $736 25%
Comm Oxford $55 - $736 25%
Comm First Health $57 - $777 25%
Comm Connecticare $58 - $777 26%
Comm Consolidated Health $58 - $777 26%
Comm Harvard $58 - $777 26%
Comm Other $58 - $777 26%
Comm Phcs $58 - $777 26%
Comm Self Pay $58 - $777 26%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals