CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Trinity Health Livingston Hospital
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $210
- Cash Discount Price: $16,064
- vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Trinity Health Livingston Hospital is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,064. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.94x the Medicare baseline. Located in 620 Byron Rd, Howell, MI.
Cash / Self-Pay
$16,064
Average discount available for prompt cash payment at this facility.
Insurance Median
$210
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: $16,064 (7180%)
Insurance Median: $210 (94%)
Cash: $16,064 (7180% of Medicare)
Ins. Median: $210 (94% 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 |
|---|---|---|
| U Of M Health Plan | $16 | 7% |
| Blue Cross Blue Shield | $18 - $5,916 | 8% |
| Bcn Domestic | $30 | 13% |
| Blue Benefit Administrators Of Massachusetts | $30 | 13% |
| Blue Care Network | $30 | 13% |
| Blue Distinction Transplant | $30 | 13% |
| Blue Shield - Ca | $30 | 13% |
| Blue Shield - Id (Regence) | $30 | 13% |
| Blue Shield - Ny Highmark Northeastern | $30 | 13% |
| Blue Shield - Ny Highmark Western | $30 | 13% |
| Blue Shield - Pa (Highmark) | $30 | 13% |
| Blue Shield - Wa (Regence) | $30 | 13% |
| Health Choices | $30 - $222 | 13% |
| Kaiser Domestic | $30 | 13% |
| Asr Health Benefits | $47 | 21% |
| Caresource | $47 | 21% |
| Hap | $47 - $210 | 21% |
| Varipro | $47 | 21% |
| Wc Accident Fund | $59 | 26% |
| Wc Advantage | $59 | 26% |
| Wc Aig | $59 | 26% |
| Wc Allied | $59 | 26% |
| Wc Amerisure | $59 | 26% |
| Wc Amtrust | $59 | 26% |
| Wc Asu Risk Mgt | $59 | 26% |
| Wc Berkley Admin | $59 | 26% |
| Wc Broadspire | $59 | 26% |
| Wc Bunch & Associates | $59 | 26% |
| Wc Ccmsi | $59 | 26% |
| Wc Emc Insurance Company | $59 | 26% |
| Wc Esis | $59 | 26% |
| Wc Fcci | $59 | 26% |
| Wc Federated | $59 | 26% |
| Wc Gallagher Bassett | $59 | 26% |
| Wc Genex Care For Ohio | $59 | 26% |
| Wc Guard Insurance Company | $59 | 26% |
| Wc Hartford | $59 | 26% |
| Wc Liberty Mutual | $59 | 26% |
| Wc Meijers | $59 | 26% |
| Wc Michigan | $59 | 26% |
| Wc Mitchell Frankenmuth | $59 | 26% |
| Wc Pma | $59 | 26% |
| Wc Sedgwick | $59 | 26% |
| Wc Sentry | $59 | 26% |
| Wc Travelers | $59 | 26% |
| Wc Tristar | $59 | 26% |
| Wc Walmart | $59 | 26% |
| Wc Zurich | $59 | 26% |
| Aetna | $105 - $5,916 | 47% |
| Medicaid / KanCare | $122 - $3,443 | 55% |
| Acs Benefit Services | $128 | 57% |
| Allied Benefit Systems | $128 | 57% |
| Claimchoice Adminstrators | $128 | 57% |
| Consociate | $128 | 57% |
| Cypress Benefit Administrators | $128 | 57% |
| Forest County Potawatomi | $128 | 57% |
| Health Smart | $128 | 57% |
| Healthgram | $128 | 57% |
| Healthscope | $128 | 57% |
| Secureone Preferred United Plans | $128 | 57% |
| Sisco Benefits | $128 | 57% |
| The Health Plan | $128 | 57% |
| Trustmark Small Business Benefits | $128 | 57% |
| Unified Group Services | $128 | 57% |
| Webtpa | $128 | 57% |
| Geha | $183 - $199 | 82% |
| Meritain | $183 | 82% |
| Priority Health | $189 - $210 | 84% |
| Hospice Advantage | $190 | 85% |
| UnitedHealthcare | $199 - $6,218 | 89% |
| Huron Valley Pace | $208 - $5,735 | 93% |
| 1199 National Benefit Fund | $209 | 93% |
| Allied National Global Care | $209 | 93% |
| Asrm - Reliance Standard Life Insurance | $209 | 93% |
| Christian Care Ministry | $209 | 93% |
| Dean Health | $209 | 93% |
| Fallon Health | $209 | 93% |
| Family Life Insurance Company | $209 | 93% |
| Ghc Scw | $209 | 93% |
| Group Pension Administrators | $209 | 93% |
| International Benefit Administrators | $209 | 93% |
| Lifetime Benefit Solutions | $209 | 93% |
| Manhattan Life | $209 | 93% |
| Medi Share | $209 | 93% |
| Multiplan | $209 | 93% |
| Mvp | $209 | 93% |
| Pai | $209 | 93% |
| Pan-American Life | $209 | 93% |
| Paramount Hmo | $209 | 93% |
| Phcs | $209 | 93% |
| Trinity Health Share | $209 | 93% |
| Health Partners | $210 | 94% |
| Tufts Health Plan | $210 | 94% |
| Cigna | $211 | 94% |
| Blue Care Network Advantage | $214 - $5,916 | 96% |
| Hospice Of Lansing | $214 - $5,916 | 96% |
| Medicare (plans) | $214 - $6,037 | 96% |
| Prime Health Services | $218 | 97% |
| Align Senior Care | $219 - $6,037 | 98% |
| Angela Hospice | $219 - $6,047 | 98% |
| Access Health | $222 | 99% |
| Acclaim | $222 | 99% |
| Administrative Concepts | $222 | 99% |
| Allegeant | $222 | 99% |
| Ameriben | $222 | 99% |
| American Family | $222 | 99% |
| American Healthcare Alliance | $222 | 99% |
| American National | $222 | 99% |
| American Republic | $222 | 99% |
| Amerihealth | $222 | 99% |
| Aultcare | $222 | 99% |
| Automated Benefit Services | $222 | 99% |
| Auxiant | $222 | 99% |
| Benefit Administrative Systems,Llc | $222 | 99% |
| Boon Chapman | $222 | 99% |
| Cam Administrative Services | $222 | 99% |
| Christian Brother Services | $222 | 99% |
| Christian Brothers Holy Cross | $222 | 99% |
| Comprehensive Benefits | $222 | 99% |
| Continental Life Insurance | $222 | 99% |
| Coventry | $222 | 99% |
| Custom Benefit Administrators | $222 | 99% |
| Employee Benefit Concepts | $222 | 99% |
| Employee Benefit Management | $222 | 99% |
| Enterprise Group Planning | $222 | 99% |
| Freedom Life Insurance Company | $222 | 99% |
| Group Administrators | $222 | 99% |
| Group Marketing Services | $222 | 99% |
| Guardian | $222 | 99% |
| Health America | $222 | 99% |
| Healthcare Management Admin | $222 | 99% |
| Healthez | $222 | 99% |
| Humana | $222 | 99% |
| Insight | $222 | 99% |
| Intercare | $222 | 99% |
| Jfp Benefit Management | $222 | 99% |
| Jp Farley Corporation | $222 | 99% |
| Key Benefit Administrator | $222 | 99% |
| Liberty Union Life Assurance Co | $222 | 99% |
| Lucent Health | $222 | 99% |
| Luminare Health | $222 | 99% |
| Luminare Health (Detroit) | $222 | 99% |
| Magnacare | $222 | 99% |
| Medben | $222 | 99% |
| Medcost | $222 | 99% |
| Medical Mutual | $222 | 99% |
| Mutual Health Services | $222 | 99% |
| Mutual Of Omaha | $222 | 99% |
| Ncas | $222 | 99% |
| Nippon Life Ins | $222 | 99% |
| Nova | $222 | 99% |
| Painters Union Insurance Fund | $222 | 99% |
| Physicians Mutual | $222 | 99% |
| Plumbers Local 98 Insurance Fund | $222 | 99% |
| Prairie States | $222 | 99% |
| Preferred One | $222 | 99% |
| Primary Physician Care | $222 | 99% |
| Professional Benefit Administrators | $222 | 99% |
| Siho Insurance Services | $222 | 99% |
| The Loomis Company | $222 | 99% |
| Unicare | $222 | 99% |
| Us Health And Life | $222 | 99% |
| Valenz | $222 | 99% |
| Western & Southern Financial Group | $222 | 99% |
| Wps | $222 | 99% |
| First Health | $227 | 101% |
| Cca - Zing Health | $231 - $6,389 | 103% |
| Correctional Healthcare Consultants | $241 | 108% |
| Three Rivers Provider Network | $245 | 110% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $246 - $6,803 | 110% |
| Cmh Washtenaw County | $272 | 122% |
| Molina Marketplace | $284 - $7,848 | 127% |
| Health Cost Solutions | $339 - $9,357 | 152% |
| Vitalcore | $339 - $9,357 | 152% |
| Wellpath | $339 - $9,357 | 152% |
| Employee Benefit Logistic | $492 - $13,583 | 220% |