CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Newark Beth Israel Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $372
  • Cash Discount Price: $135
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Newark Beth Israel Medical Center is $372. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.66x the Medicare baseline. Located in 201 Lyons Ave, Newark, NJ.
Cash / Self-Pay
$135

Average discount available for prompt cash payment at this facility.

Insurance Median
$372

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: $135 (60%)
Insurance Median: $372 (166%)
Cash: $135 (60% of Medicare)
Ins. Median: $372 (166% 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
Blue Cross Blue Shield $111 - $606 50%
UnitedHealthcare $147 - $383 66%
Aetna $161 - $324 72%
Fidelis Care $168 - $228 75%
Clover Health $228 102%
Humana $228 102%
Wellpoint $228 - $370 102%
Cigna $374 - $501 167%
First Health $389 174%
Amerihealth $449 201%
Wellcare $454 203%
Emblem Health $456 204%
Qualcare Inc $498 - $532 223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Lyons Ave, Newark, NJ 07112
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals