CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Greater Baltimore Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $9
Cash Discount Price: $76
vs. Medicare Baseline: 0.04x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Greater Baltimore Medical Center is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.04x the Medicare baseline. Located in 6701 North Charles Street, Baltimore, MD.

Cash / Self-Pay

$76

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $76 (34%)

Insurance Median: $9 (4%)

Cash: $76 (34% of Medicare)

Ins. Median: $9 (4% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$9 - $21	4%
Alterwood Health [290]	$9	4%
Carefirst Maryland Health Advantage Mca [264]	$9	4%
Carefirst [201]	$9 - $22	4%
Cfchp Mco [239]	$9	4%
Cigna	$9 - $17	4%
Communicare Advantage [300]	$9	4%
Humana	$9	4%
Jai Medical Services [236]	$9	4%
Johns Hopkins [213]	$9 - $12	4%
Keycare Advantage [299]	$9	4%
Md Physician Care [237]	$9	4%
Medicaid / KanCare	$9	4%
Medicare (plans)	$9	4%
Multiplan/Phcs [296]	$9 - $10	4%
Priority Partners [241]	$9	4%
Provider Partners Health Plan [298]	$9	4%
UnitedHealthcare	$9 - $22	4%
Wellpoint [235]	$9	4%
First Health Network [268]	$11	5%
Kaiser Permanente Hmo [231]	$12	5%
Usa Managed Care Organization [301]	$13	6%
Carefirst Blue Choice Hmo [253]	$14 - $20	6%
Carefirst Administrator [252]	$15 - $22	7%
All Payers	$137 - $1,644	61%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $76.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Greater Baltimore Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.