CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Ascension River District Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $199
  • Cash Discount Price: $64
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Ascension River District Hospital is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.89x the Medicare baseline. Located in 4100 River Rd, East China, MI.
Cash / Self-Pay
$64

Average discount available for prompt cash payment at this facility.

Insurance Median
$199

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: $64 (29%)
Insurance Median: $199 (89%)
Cash: $64 (29% of Medicare)
Ins. Median: $199 (89% 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
Ahlic $20 9%
Hap Hmo $20 9%
Hap Preferred $20 9%
Ppom $21 9%
Meridian Health Plan $79 35%
Medicare (plans) $189 - $209 84%
Amerihealth Vip Care $197 88%
Aetna $199 89%
Great Lakes Health Plan $199 89%
Harbor Advantage Hmo $199 89%
Tricare $199 89%
Veterans Choice $199 89%
Humana $201 90%
Total Health Care $201 90%
Meridian Wellcare $209 93%
Molina Advantage $209 93%
Molina Health Link $209 93%
Ambetter / Centene $249 111%
Molina Market Place $249 111%
Smarthealth $279 125%
Aaa-Auto Insurance $379 169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4100 River Rd, East China, MI 48054
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals