CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Hackensack Meridian Mountainside Medical

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $361
  • Cash Discount Price: $262
  • vs. Medicare Baseline: 1.61x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Hackensack Meridian Mountainside Medical is $361. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $262. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.61x the Medicare baseline. Located in 1 Bay Avenue, Montclair, NJ.
Cash / Self-Pay
$262

Average discount available for prompt cash payment at this facility.

Insurance Median
$361

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: $262 (117%)
Insurance Median: $361 (161%)
Cash: $262 (117% of Medicare)
Ins. Median: $361 (161% 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
Healthscope Benefits [2290] $45 - $361 20%
UnitedHealthcare $45 20%
Aetna $65 - $373 29%
Black Lung [6055] $174 78%
Create Flex / Select [3580] $174 78%
Healthcare Highways [2210] $174 - $361 78%
Lucent Health [6000] $174 78%
Medicare (plans) $174 78%
Oncology Patient Assistance Programs [2295] $174 78%
Selecthealth [3740] $174 78%
Web Tpa [2115] $174 - $373 78%
Worker'S Comp [2125] $174 - $395 78%
Wtc Healthcare Sme Karna [8005] $174 78%
First Health [1375] $319 - $361 143%
Cigna $340 - $413 152%
Administrative Concepts [1005] $361 161%
Allied National Global Care [1035] $361 161%
Gilsbar [1425] $361 161%
Healthcost Solutions [2415] $361 161%
Healthfirst [2395] $361 161%
Healthnet [1495] $361 161%
Hometown Health [2155] $361 161%
Mayo Clinic Health Solutions [2280] $361 161%
Multiplan [1680] $361 161%
Mutual Of Omaha [1685] $361 161%
New Era Life Insurance Company [1705] $361 161%
Pan American Life Insurance Co [1770] $361 161%
Pba [1775] $361 161%
Phcs [1780] $361 161%
Planned Administrators Inc [2360] $361 161%
Resource One Administrators [2815] $361 161%
Trustmark [2030] $361 161%
Universal Fidelity [2085] $361 161%
1199 Seiu Benefit Fund [3505] $373 167%
Allied Benefit Systems Inc [1030] $373 167%
Meritain Health [1655] $373 167%
Emblem Health [2430] $395 177%
Humana $395 177%
Mvp Health Plan [2180] $413 185%
National Association Of Letter Carriers [1695] $413 185%
Samba Health [2305] $413 185%
Amerihealth [3520] $425 190%
Mva [1690] $425 190%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Bay Avenue, Montclair, NJ 07042
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals