CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Raritan Bay Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $402
  • Cash Discount Price: $225
  • vs. Medicare Baseline: 1.80x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Raritan Bay Medical Center is $402. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.80x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.
Cash / Self-Pay
$225

Average discount available for prompt cash payment at this facility.

Insurance Median
$402

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: $225 (101%)
Insurance Median: $402 (180%)
Cash: $225 (101% of Medicare)
Ins. Median: $402 (180% 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
Karna $15 7%
Aetna $70 - $471 31%
Horizon $92 - $505 41%
Clover $94 42%
Seoul Medical Group $108 48%
Blue Cross Blue Shield $225 101%
Vaccn $225 101%
Wellcare $225 101%
United Community/Americhoice $237 106%
Amerigroup $241 108%
UnitedHealthcare $270 - $2,682 121%
Qualcare $348 - $475 156%
Activecare First McO $392 175%
Bergen Risk $392 175%
Oxford $396 177%
Cigna $418 - $500 187%
Multiplan - PHCS $445 199%
Amerihealth $453 - $509 202%
Brighton Health Plan $471 211%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 New Brunswick Ave, Perth Amboy, NJ 08861
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals