CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: St Joe Mercy Hospital System Livonia

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $12
  • Cash Discount Price: $22,559
  • vs. Medicare Baseline: 0.05x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at St Joe Mercy Hospital System Livonia is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22,559. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.05x the Medicare baseline. Located in 36475 Five Mile Road, Livonia, MI.
Cash / Self-Pay
$22,559

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $22,559 (10084%)
Insurance Median: $12 (5%)
Cash: $22,559 (10084% of Medicare)
Ins. Median: $12 (5% 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
Aetna $5 - $10,384 2%
Albany County Correctional Facility $5 2%
Ambetter / Centene $5 2%
Amish Mennonite $5 2%
Ascension St. Vincent Public Safety Medical $5 2%
Bccp $5 2%
Blue Cross Blue Shield $5 - $10,384 2%
Bmc Healthnet $5 2%
Breast Grant-Connecticut $5 2%
Broward County Dept Of Health $5 2%
California Health And Wellness $5 2%
Cardinal Innovations Lme $5 2%
Care Connections Of Northern Iowa $5 2%
Care Oregon Ohp $5 2%
Cencal Health Plan $5 2%
Cenpatico $5 2%
Chhuny $5 2%
Childrens Comm Health Plan $5 2%
Childrens Medical Services Title 19 $5 2%
Cigna $5 - $218 2%
City Of Philadelphia $5 2%
Cmh Allegan County $5 2%
Cmh Ausable Valley $5 2%
Cmh Barry County $5 2%
Cmh Bay-Arenac County $5 2%
Cmh Berrien County $5 2%
Cmh Cass County $5 2%
Cmh Central Mi County $5 2%
Cmh Clinton-Eaton-Ingham County $5 2%
Cmh Detroit Wayne Integrated Health Network $5 - $272 2%
Cmh Genesee County $5 2%
Cmh Ionia County $5 2%
Cmh Jackson County/Lifeways $5 2%
Cmh Kalamazoo $5 2%
Cmh Kent County $5 2%
Cmh Lenawee County $5 - $272 2%
Cmh Livingston County $5 - $272 2%
Cmh Macomb $5 2%
Cmh Misc $5 - $272 2%
Cmh Monroe County $5 - $272 2%
Cmh Montcalm County $5 2%
Cmh Muskegon County $5 2%
Cmh Newaygo County $5 2%
Cmh North Country $5 2%
Cmh Northern Lakes County $5 2%
Cmh Oakland County $5 2%
Cmh Ottawa County $5 2%
Cmh Van Buren County $5 2%
Cmh Washtenaw County $5 - $272 2%
Cmh Wayne County/Carelink $5 2%
Cmh Wayne Cty/Com Liv Svcs $5 2%
Cmh West Mi County $5 2%
Community Benefit Health $5 2%
Community Care Behavorial Health $5 2%
Community Care Partners $5 2%
Community Health Choice $5 2%
Connections Csp $5 2%
County Coroner $5 2%
County Funding Generic $5 2%
Covid19 Hrsa Uninsured Testing And Treatment Fund $5 2%
Dean Wi Badgercare $5 2%
Delaware County Department Of Health $5 2%
Delaware First Health $5 2%
Delta Dental Nj $5 2%
Dph Tb Program $5 2%
Dscc $5 2%
Eastpointe Lme $5 2%
Family Health Network $5 2%
Freedom First Healthcare $5 2%
Fresno County Ccs $5 2%
Ghc Scw Wi Badgercare $5 2%
Harbor Health $5 2%
Health Safety Net $5 2%
Healthy Blue Ne $5 2%
Hennepin Health $5 2%
Humana $5 - $173 2%
Id County Ada $5 2%
Id County Canyon $5 2%
Id County Cat Fund $5 2%
Id County Other $5 2%
Id County Payette $5 2%
Idaho Dept Health And Wellfare $5 2%
Idaho Womens Health Check $5 2%
Indiana Breast Cervical Cancer $5 2%
Inland Empire Health Plan $5 2%
Intercommunity Health Ohp $5 2%
Iowa Total Care $5 2%
Jai Medical System $5 2%
Kern Family Health Plan $5 2%
Keystone First $5 2%
Keystone First Chip $5 2%
La Care Health Plan $5 2%
Lakeland Care Inc $5 2%
Managed Health Services - Indiana $5 2%
Maryland Breast & Cervical Program $5 2%
Maryland Healthy Smiles - Scion Dental $5 2%
Maryland Physicians Care $5 2%
Massachusetts Behavioral Health Partnership $5 2%
Mdwise $5 2%
Medi-Cal $5 2%
Medi-Cal Healthnet $5 2%
Medicaid / KanCare $5 - $5,937 2%
Medstar Dc Healthy Family $5 2%
Medstar Md Health Choice $5 2%
Mo Home State Health Plan $5 2%
Molina Centennial Care $5 2%
Nascentia Health Options $5 2%
Nebraska Total Care $5 2%
New York Cancer Services Program $5 2%
Nextlevel Health $5 2%
Oregon Screenwise $5 2%
Pace Of Southwest Michigan $5 - $8 2%
Paramount Advantage $5 2%
Parkland Community Health Plan $5 2%
Partners Behavioral Lme $5 2%
Peach State Healthplan $5 2%
Philadelphia County Funding $5 2%
Presbyterian Centennial Care $5 2%
Prestige Health Choice $5 2%
Priority Partners $5 2%
Robert F Sing Program $5 2%
Rx 340B Pass Along $5 2%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $5 2%
Rx Medi-Cal $5 2%
Rx Meridian Rx $5 2%
Ryan White Florida Mssrp $5 2%
Sandhills Center Lme $5 2%
Screening For Life $5 2%
St Joseph County Hlth Dpt $5 2%
Stephenson Cty Health $5 2%
Sunshine State Health Plan $5 2%
Superior Health $5 2%
Tenncare $5 2%
Texas Children'S Health Plan $5 2%
Trillium Community Ohp $5 2%
Tufts Health Public Plans $5 2%
UnitedHealthcare $5 - $10,914 2%
Vaya Health Lme $5 2%
Washtenaw Health Plan $5 2%
Wellsense Health Plan $5 2%
Wi Womens Wellness $5 2%
Ally Align Care Adv $8 4%
American Health Advantage Of Idaho $8 4%
American Health Plan $8 4%
Aurora Special Needs $8 4%
Blue Care Network Advantage $8 - $10,384 4%
Blue Shield - De (Highmark) Medciare Advantage $8 4%
Care Dimensions $8 4%
Care Improvement Plus $8 4%
Care Resources Pace $8 4%
Careplus Health Plans $8 4%
Cca Senior Care Options $8 4%
Central Valley Medical Services Corp Pace $8 4%
Champion Health Plan Mcr Advantage $8 4%
Champva $8 4%
Clear Spring Health $8 4%
Clover Health $8 4%
Commonwealth Care Alliance $8 4%
Community Pace At Home $8 4%
Eddy Senior Care-Pace $8 4%
Eddy Seniorcare Pace $8 4%
Elementcare $8 4%
Evercare $8 4%
Everence $8 4%
Gateway Health Plan $8 4%
Genesys Pace Of Genesee County $8 4%
Georgia Health Advantage $8 4%
Gold Advantage $8 4%
Gpa Croell Redi Mix $8 4%
Health America Advantra $8 4%
Highmark Health Options Dual Plan $8 4%
Hope Select Pace $8 4%
Horizon Nj Total Care $8 4%
Hudson Headwaters Pace $8 4%
Huron Valley Pace $8 4%
Innovative Integrated Health Community Plans $8 4%
Iowa Health Advantage $8 4%
Johns Hopkins Advantage Md $8 4%
Lasso Healthcare Msa $8 4%
Life St Marys Pace $8 4%
Lifecircles Pace $8 4%
Longevity Health Plan $8 4%
Martins Point Generations Advantage $8 4%
Mass General Brigham Mcr Adv $8 4%
Medicare (plans) $8 - $11,126 4%
Medipak Advantage $8 4%
Mercy Life $8 4%
Mercyone Cedar Valley $8 4%
Meridian Complete $8 4%
Michigan Complete Health $8 4%
Nascentia Health Plus $8 4%
New Centry Health Careplus $8 4%
Osu Prime Care Advantage $8 4%
Pace Cny $8 4%
Pace Iowa Immanuel Pathways $8 4%
Pace Southeast $8 4%
Pace-Trinity Health $8 4%
Peak Pace Solutions $8 4%
Perennial Advantage $8 4%
Preferred Care Partners $8 4%
Presbyterian Senior Plan $8 4%
Provider Partners Health Plan Of Illinois $8 4%
Provider Partners Health Plan Of Indiana $8 4%
Pruitthealth Premier $8 4%
Reliance Community Care Partners Care Resources Pace $8 4%
Rx Allwin $8 4%
Rx Grane Grnmedd $8 4%
Rx Retiree Rx Care $8 4%
Scan Health Plan Mcr Ipa Meritage Oon $8 4%
Secure Horizons Ma Pffs $8 4%
Serenity Pace $8 4%
Siouxland Pace $8 4%
Solis Health Plans $8 4%
Sunnyview-Pace Finance Dept $8 4%
Texan Plus $8 4%
The Health Plan $8 - $116 4%
Thome Pace $8 4%
Todays Options $8 4%
Tribute Health Plans $8 4%
Tricare $8 4%
Triwest Health Alliance $8 4%
Um Health Advantage $8 4%
Union Health Service $8 4%
Us Family Health Plan $8 4%
Veterans Eval Services $8 4%
Welbe Health $8 4%
Wellmed $8 4%
Align Senior Care $9 - $10,596 4%
Cca - Zing Health $9 - $11,215 4%
Veterans Administration $9 4%
Longevity Ipa Of Michigan Llc Health Plan Isnp $10 - $11,942 4%
Wc Accident Fund $11 - $77 5%
Wc Advantage $11 - $77 5%
Wc Aig $11 - $77 5%
Wc Allied $11 - $77 5%
Wc Amerisure $11 - $77 5%
Wc Amtrust $11 - $77 5%
Wc Asu Risk Mgt $11 - $77 5%
Wc Berkley Admin $11 - $77 5%
Wc Broadspire $11 - $77 5%
Wc Bunch & Associates $11 - $77 5%
Wc Ccmsi $11 - $77 5%
Wc Emc Insurance Company $11 - $77 5%
Wc Esis $11 - $77 5%
Wc Fcci $11 - $77 5%
Wc Federated $11 - $77 5%
Wc Gallagher Bassett $11 - $77 5%
Wc Genex Care For Ohio $11 - $77 5%
Wc Guard Insurance Company $11 - $77 5%
Wc Hartford $11 - $77 5%
Wc Liberty Mutual $11 - $77 5%
Wc Meijers $11 - $77 5%
Wc Michigan $11 - $77 5%
Wc Mitchell Frankenmuth $11 - $77 5%
Wc Pma $11 - $77 5%
Wc Sedgwick $11 - $77 5%
Wc Sentry $11 - $77 5%
Wc Travelers $11 - $77 5%
Wc Tristar $11 - $77 5%
Wc Walmart $11 - $77 5%
Wc Zurich $11 - $77 5%
1199 National Benefit Fund $12 - $174 5%
Allied National Global Care $12 - $174 5%
Andrie Inc $12 5%
Asrm - Reliance Standard Life Insurance $12 - $174 5%
Blue Care Network $12 - $20 5%
Christian Care Ministry $12 - $174 5%
Dean Health $12 - $174 5%
East Greenbush Central School District $12 5%
Fallon Health $12 - $174 5%
Family Life Insurance Company $12 - $174 5%
Genex Wc $12 5%
Healthsmart Workers Comp $12 5%
International Benefit Administrators $12 - $174 5%
Jag Source $12 5%
Lifetime Benefit Solutions $12 - $174 5%
Manhattan Life $12 - $174 5%
Molina Marketplace $12 - $13,775 5%
Multiplan $12 - $174 5%
Mvp $12 - $174 5%
New York State Insurance Fund $12 5%
Njm Insurance Group $12 5%
Pai $12 - $174 5%
Pan-American Life $12 - $174 5%
Partners Direct Health - Brio $12 5%
Phcs $12 - $174 5%
Rx Heatlhcomp $12 5%
Rx Restat $12 5%
Rx Saif Opdp Wc $12 5%
Rx Worker'S Comp $12 5%
Trinity Health Share $12 - $174 5%
Wc Ace $12 5%
Wc Acs Federal Employees $12 5%
Wc Acuity $12 5%
Wc Aegis $12 5%
Wc Aims $12 5%
Wc Alaska National Ins $12 5%
Wc Align Network $12 5%
Wc Am Trust N America $12 5%
Wc American Claims Mgmt $12 5%
Wc Benetech $12 5%
Wc Broward County $12 5%
Wc California State Comp Ins $12 5%
Wc California State Ins Fund $12 5%
Wc Capitol Area Health Consortium $12 5%
Wc Chartis $12 5%
Wc Chubb $12 5%
Wc Cirma $12 5%
Wc City Of Albany $12 5%
Wc City Of Sioux City $12 5%
Wc Claims Mgmt Inc $12 5%
Wc Cna $12 5%
Wc Comp One Admin C/O Manageability $12 5%
Wc Compone Admin $12 5%
Wc Corvel $12 5%
Wc Ct Healthcare Trust $12 5%
Wc Donegal Insurance Group $12 5%
Wc Employee Mutual $12 5%
Wc Enablecomp $12 5%
Wc Encore Health Network $12 5%
Wc Erie $12 5%
Wc Evolutions $12 5%
Wc Fed Ex $12 5%
Wc Federal Black Lung $12 5%
Wc Finley Occupational Health $12 5%
Wc First Agency/Occunet $12 5%
Wc Ford Motor $12 5%
Wc Fresno Unified Emp $12 5%
Wc General Motors $12 5%
Wc Generic $12 5%
Wc Great West Casualty $12 5%
Wc Guarantee Insurance $12 5%
Wc Hab $12 5%
Wc Hastings $12 5%
Wc Health Management $12 5%
Wc Heritage Summit $12 5%
Wc Hireright $12 5%
Wc Horizon $12 5%
Wc Icw Group $12 5%
Wc Idaho State Ins Fund $12 5%
Wc Intercare Insurance $12 5%
Wc Intermountain $12 5%
Wc Johns Eastern $12 5%
Wc Kemberton $12 5%
Wc Key Ins & Benefit Solutions $12 5%
Wc Mac Risk Management $12 5%
Wc Massachusetts $12 5%
Wc Mdia $12 5%
Wc Meadowbrook Claim $12 5%
Wc Medical Administrators $12 5%
Wc Memic $12 5%
Wc Mercy Workcare $12 5%
Wc Michigan Millers Mutual $12 5%
Wc Mra $12 5%
Wc Nationwide $12 5%
Wc Nca Comp $12 5%
Wc New York $12 5%
Wc New York Special Funds $12 5%
Wc North American Rishces $12 5%
Wc Northeast Health $12 5%
Wc Notre Dame $12 5%
Wc Novanet $12 5%
Wc O'Hara Corp $12 5%
Wc Occ Health Allen $12 5%
Wc Ohio Bureau $12 5%
Wc One Call Medical $12 5%
Wc Paradigm $12 5%
Wc Peerless $12 5%
Wc Praxis Health Network $12 5%
Wc Price Chopper $12 5%
Wc Procura Management $12 5%
Wc Qualcare $12 5%
Wc Quiktrip $12 5%
Wc Reny Company $12 5%
Wc Rev Claims $12 5%
Wc Risico $12 5%
Wc Rural Mutual $12 5%
Wc Saif Oregon $12 5%
Wc Secura $12 5%
Wc Sheakley Unicomp $12 5%
Wc Smile Lodge $12 5%
Wc Society $12 5%
Wc Srs $12 5%
Wc Taconic (Mro) $12 5%
Wc Taconic Farms $12 5%
Wc Triad Group $12 5%
Wc Troy Ny $12 5%
Wc Tyson $12 5%
Wc Unified Health Services $12 5%
Wc United Heartland $12 5%
Wc Us Dept Of Labor $12 5%
Wc Velocity $12 5%
Wc West Bend $12 5%
Wc West Bend Mutual/Argent $12 5%
Wc Winnebago Industries $12 5%
Wc Yankee Trails $12 5%
Wc York Risk $12 5%
Wc Zenith $12 5%
Wellpath $12 - $16,424 5%
Acclaim $13 - $173 6%
Administrative Concepts $13 - $173 6%
Allegeant $13 - $173 6%
Allied Benefit Systems $13 - $116 6%
Ameriben $13 - $173 6%
American Family $13 - $173 6%
American Healthcare Alliance $13 - $173 6%
American National $13 - $173 6%
American Republic $13 - $173 6%
Amerihealth $13 - $173 6%
Aultcare $13 - $173 6%
Automated Benefit Services $13 - $173 6%
Auxiant $13 - $173 6%
Benefit Administrative Systems,Llc $13 - $173 6%
Blue Benefit Administrators Of Massachusetts $13 - $20 6%
Blue Distinction Transplant $13 - $20 6%
Blue Shield - Ca $13 - $20 6%
Blue Shield - Id (Regence) $13 - $20 6%
Blue Shield - Ny Highmark Northeastern $13 - $20 6%
Blue Shield - Ny Highmark Western $13 - $20 6%
Blue Shield - Pa (Highmark) $13 - $20 6%
Blue Shield - Wa (Regence) $13 - $20 6%
Boon Chapman $13 - $173 6%
Cam Administrative Services $13 - $173 6%
Christian Brother Services $13 - $173 6%
Christian Brothers Holy Cross $13 - $173 6%
Claimchoice Adminstrators $13 - $116 6%
Claimdoc $13 6%
Comprehensive Benefits $13 - $173 6%
Consociate $13 - $116 6%
Continental Life Insurance $13 - $173 6%
Coventry $13 - $218 6%
Custom Benefit Administrators $13 - $173 6%
Cypress Benefit Administrators $13 - $116 6%
Employee Benefit Concepts $13 - $173 6%
Employee Benefit Management $13 - $173 6%
Enterprise Group Planning $13 - $173 6%
First Health $13 - $178 6%
Forest County Potawatomi $13 - $116 6%
Freedom Life Insurance Company $13 - $173 6%
Group Administrators $13 - $173 6%
Group Marketing Services $13 - $173 6%
Group Pension Administrators $13 - $174 6%
Guardian $13 - $173 6%
Health America $13 - $173 6%
Health Choices $13 - $173 6%
Health Smart $13 - $116 6%
Healthcare Management Admin $13 - $173 6%
Healthez $13 - $173 6%
Healthgram $13 - $116 6%
Healthscope $13 - $116 6%
Insight $13 - $173 6%
Intercare $13 - $173 6%
Jfp Benefit Management $13 - $173 6%
Jp Farley Corporation $13 - $173 6%
Kent County Jail $13 6%
Key Benefit Administrator $13 - $173 6%
Liberty Union Life Assurance Co $13 - $173 6%
Lucent Health $13 - $173 6%
Luminare Health $13 - $173 6%
Luminare Health (Detroit) $13 - $158 6%
Magnacare $13 - $173 6%
Medben $13 - $173 6%
Medcost $13 - $173 6%
Medical Mutual $13 - $173 6%
Muskegon County Jail $13 6%
Mutual Health Services $13 - $173 6%
Mutual Of Omaha $13 - $173 6%
Ncas $13 - $173 6%
Nippon Life Ins $13 - $173 6%
Nova $13 - $173 6%
Painters Union Insurance Fund $13 - $173 6%
Physicians Mutual $13 - $173 6%
Plumbers Local 98 Insurance Fund $13 - $173 6%
Prairie States $13 - $173 6%
Preferred One $13 - $173 6%
Primary Physician Care $13 - $173 6%
Professional Benefit Administrators $13 - $173 6%
Secureone Preferred United Plans $13 - $116 6%
Siho Insurance Services $13 - $173 6%
Sisco Benefits $13 - $116 6%
The Loomis Company $13 - $173 6%
Trustmark Small Business Benefits $13 - $116 6%
Unicare $13 - $173 6%
Unified Group Services $13 - $116 6%
Us Health And Life $13 - $173 6%
Valenz $13 - $173 6%
Webtpa $13 - $116 6%
Western & Southern Financial Group $13 - $173 6%
Wps $13 - $173 6%
Meritain $14 - $158 6%
American Postal Workers Secondary $16 7%
Mclaren Health $16 7%
U Of M Health Plan $16 - $31 7%
Priority Health $17 - $200 8%
Asr Health Benefits $18 - $51 8%
Hap $18 - $167 8%
Health Partners $18 - $167 8%
Tufts Health Plan $18 - $167 8%
Varipro $18 - $51 8%
Bcn Domestic $20 9%
Kaiser Domestic $20 9%
Bcccp-Michigan $23 - $47 10%
Caresource $51 23%
Acs Benefit Services $116 52%
Geha $158 - $174 71%
Access Health $173 77%
Ghc Scw $174 78%
Medi Share $174 78%
Paramount Hmo $174 78%
Hospice Of Michigan $214 - $10,384 96%
Angela Hospice $218 - $10,596 97%
Prime Health Services $218 97%
Three Rivers Provider Network $245 110%
Carelon Behavioral Health $272 122%
Magellan Behavioral Health $272 122%
Health Cost Solutions $338 - $16,424 151%
Vitalcore $338 - $16,424 151%
Employee Benefit Logistic $491 - $23,841 219%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 36475 Five Mile Road, Livonia, MI 48154
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals