CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Community Medical Center

Billing Code: 94640 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$227

about 1.0× the $224 Medicare rate · typically $82–$269

modeled estimate · not a bill or quote

What this hospital charges insurers

$225

About the fair price

about $2 under the fair price · 1.0× Medicare

Medicare pays $224 Fair price $227 This hospital $225 Cash price $133 Hospital's list price $641

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

A typical price — 1 charge more and 4 charge less, among the 9 NJ hospitals compared.

Cheapest $29 Priciest $226

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

A fair price for a Breathing treatment (nebulizer) is about $227 (about 1.0× the $224 Medicare rate). Community Medical Center charges insurers about $225, or about $133 in cash — about the fair price. Located in Toms River, NJ.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$80 - $383	36%
Blue Cross Blue Shieldmajor	$63 - $586	28%
Aetnamajor	$87 - $353	39%
Cignamajor	$381 - $510	170%
Humanamajor	$222	99%
AmeriHealth	$478	214%
Clover Health	$222	99%
Fidelis Care	$81 - $222	36%
WellCare	$442	198%
+ 2 smaller / regional plans	$389 - $456

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 133), 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 Community Medical Center 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 Community Medical Center

Compare: Breathing treatment (nebulizer) at other NJ hospitals

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