CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Alice Peck Day Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $59
Cash Discount Price: $63
vs. Medicare Baseline: 0.26x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Alice Peck Day Memorial Hospital is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.26x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.

Cash / Self-Pay

$63

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $63 (28%)

Insurance Median: $59 (26%)

Cash: $63 (28% of Medicare)

Ins. Median: $59 (26% 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
Ambetter / Centene	$10	4%
Nh Healthy Families	$10	4%
Medicaid / KanCare	$27 - $80	12%
Blue Cross Blue Shield	$29 - $156	13%
Harvard Pilgrim	$37 - $152	17%
UnitedHealthcare	$42 - $126	19%
Tufts	$43 - $128	19%
Cigna	$45 - $143	20%
Commercial Generic	$45 - $134	20%
Connecticut General	$45 - $134	20%
Klais	$46 - $135	21%
Wellpoint	$46 - $138	21%
Aetna	$53 - $158	24%
Mvp	$54 - $159	24%
Coventry Health	$56 - $166	25%
Coventry Health Wc	$56 - $166	25%
Humana	$61 - $182	27%

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 $63.
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 Alice Peck Day Memorial Hospital 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.