CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Englewood Hospital and Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $268
  • Cash Discount Price: $55
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Englewood Hospital and Medical Center is $268. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.20x the Medicare baseline. Located in 350 Engle St, Englewood, NJ.
Cash / Self-Pay
$55

Average discount available for prompt cash payment at this facility.

Insurance Median
$268

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: $55 (25%)
Insurance Median: $268 (120%)
Cash: $55 (25% of Medicare)
Ins. Median: $268 (120% 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
Multiplan $17 - $267 8%
Emblem_762 $35 16%
Horizon New Jersey Health - Dsnp $40 - $240 18%
Wellcare_755 $43 19%
Aetna $46 - $395 21%
Americhoice_756 $49 22%
Amerigroup_754 $54 24%
Horizon New Jersey Health_674 $59 26%
Hip Health Plan $216 - $327 97%
Heathnet Federal Services $220 - $409 98%
Blue Cross Blue Shield $228 - $316 102%
Americhoice_732 $240 107%
Amerigroup_758 $240 107%
Amerihealth_766 $240 107%
Clover_733 $240 107%
Humana $240 107%
UnitedHealthcare $240 - $1,598 107%
Emblem_734 $259 - $382 116%
Wellcare_765 $259 116%
Cigna $264 118%
Amerihealth_757 $283 126%
Horizon $319 - $340 143%
Magnacare_763 $327 146%
Magnacare_769 $327 146%
Health Care Support_787 $354 - $419 158%
Qualcare_752 $360 161%
Qualcare $365 163%
Magnacare_768 $382 171%
Magnacare_770 $382 171%
Bergen $409 183%
Coventry $409 183%
Amerihealth_760 $431 193%
Magnacare $436 195%
Oxford_741 $1,565 700%
Qualcare_783 $7,783 3479%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 350 Engle St, Englewood, NJ 07631
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals