CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Sanford Medical Center Fargo

Billing Code: 94640 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$147

about 0.7× the $224 Medicare rate · typically $85–$229

modeled estimate · not a bill or quote

What this hospital charges insurers

$209

Above the fair price

about $62 over the fair price · 0.9× Medicare

Medicare pays $224 Fair price $147 This hospital $209 Cash price $262 Hospital's list price $327

How we calculate the fair BaseRate →

How this hospital compares to other ND hospitals

On the higher side — 7 of 8 other ND hospitals charge less.

Cheapest $53 Priciest $221

Black dot = this hospital, among the 9 ND hospitals with a price for this procedure. Full list below.

A fair price for a Breathing treatment (nebulizer) is about $147 (about 0.7× the $224 Medicare rate). Sanford Medical Center Fargo charges insurers about $209, or about $262 in cash — above the fair price. Located in Fargo, ND.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $147. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$207 - $285	93%
Blue Cross Blue Shieldmajor	$107 - $258	48%
Aetnamajor	$209 - $280	93%
Cignamajor	$294	131%
Health Net	$294	131%
HealthPartners	$134 - $209	60%
Medica	$147 - $157	66%
Sanford Health Plan	$8 - $193	4%
Security Health Plan	$180	80%
UCare	$207 - $230	93%
+ 2 smaller / regional plans	$214 - $294

Government programs also on file: Medicare.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 262), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 94640.

Insurance Before you use insurance

Call your insurance company to confirm Sanford Medical Center Fargo is in-network.
Ask your insurer whether prior approval is required for CPT code 94640.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Sanford Medical Center Fargo

Compare: Breathing treatment (nebulizer) at other ND hospitals

Insurance negotiated median for the same procedure, sorted lowest first.