CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Sunrise Hospital and Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $17
  • Cash Discount Price: $543
  • vs. Medicare Baseline: 0.08x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Sunrise Hospital and Medical Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $543. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.08x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.
Cash / Self-Pay
$543

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $543 (243%)
Insurance Median: $17 (8%)
Cash: $543 (243% of Medicare)
Ins. Median: $17 (8% 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
Humana $6 - $14 3%
Aetna $8 - $437 4%
Alignment Health Plan $8 4%
Blue Cross Blue Shield $8 - $22 4%
Caremore $8 4%
Healthcare Partners Of Nv $8 - $10 4%
United $8 - $302 4%
Hometown Health Providers $9 - $724 4%
Multiplan $10 - $1,056 4%
Silver Summit $10 - $18 4%
Amerigroup $12 - $16 5%
Culinary Health Fund $12 - $25 5%
Health Plan Nevada $12 - $17 5%
Molina $13 - $18 6%
Cigna $14 - $36 6%
Sierra $14 - $15 6%
Community Care Health $16 7%
Molina Healthcare $16 - $17 7%
Sierra Hpn $16 7%
Ambetter / Centene $17 - $304 8%
Caresource $17 8%
Select Health $17 - $334 8%
Legacy Provider Network $34 15%
Corvel $36 - $39 16%
Comp-Med Workers Comp $37 17%
Olympus Medsave Usa $38 - $1,085 17%
Prominence Healthfirst $169 - $434 76%
Cmn Global $237 - $608 106%
Nv Health & Welfare Trust $338 - $868 151%
First Health $372 - $1,158 166%
Medcare International $423 - $1,085 189%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3186 S Maryland Pkwy, Las Vegas, NV 89109
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals