CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Capital Health Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $246
  • Cash Discount Price: $1,654
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Capital Health Regional Medical Center is $246. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,654. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.10x the Medicare baseline. Located in 750 Brunswick Ave, Trenton, NJ.
Cash / Self-Pay
$1,654

Average discount available for prompt cash payment at this facility.

Insurance Median
$246

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: $1,654 (739%)
Insurance Median: $246 (110%)
Cash: $1,654 (739% of Medicare)
Ins. Median: $246 (110% 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
Horizon Nj Health $37 17%
UnitedHealthcare $62 - $852 28%
Medicaid / KanCare $67 - $210 30%
Wellpoint $67 - $246 30%
Aetna $84 - $1,742 38%
Oxford Benefit Plan $120 54%
Blue Cross Blue Shield $156 - $587 70%
Cigna $177 - $3,680 79%
Fidelis $222 99%
Medicare (plans) $229 102%
Clover $246 110%
Humana $251 112%
Multiplan $1,326 - $4,171 593%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 750 Brunswick Ave, Trenton, NJ 08638
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals