CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Jfk University Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $370
  • Cash Discount Price: $214
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Jfk University Medical Center is $370. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $214. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.65x the Medicare baseline. Located in 65 James Street, Edison, NJ.
Cash / Self-Pay
$214

Average discount available for prompt cash payment at this facility.

Insurance Median
$370

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: $214 (96%)
Insurance Median: $370 (165%)
Cash: $214 (96% of Medicare)
Ins. Median: $370 (165% 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%
Horizon $74 - $506 33%
Aetna $88 - $489 39%
UnitedHealthcare $94 - $359 42%
Clover $98 44%
Seoul Medical Group $117 52%
Vaccn $203 - $225 91%
Amerigroup $203 - $225 91%
Wellcare $203 - $225 91%
United Community/Americhoice $214 - $237 96%
Blue Cross Blue Shield $225 101%
Oxford $317 - $332 142%
Activecare First McO $382 171%
Intergroup $382 171%
Bergen Risk $409 183%
Prime Health $436 195%
Multiplan - PHCS $463 207%
Brighton Health Plan $490 219%
Qualcare $505 226%
Amerihealth $516 231%
Cigna $525 235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 65 James Street, Edison, NJ 08818
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals