CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Albany Medical Center Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $18
  • Cash Discount Price: $24
  • vs. Medicare Baseline: 0.08x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Albany Medical Center Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.08x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.
Cash / Self-Pay
$24

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $24 (11%)
Insurance Median: $18 (8%)
Cash: $24 (11% of Medicare)
Ins. Median: $18 (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
Cdphp $5 - $241 2%
Medicare (plans) $5 - $9 2%
Blue Cross Blue Shield $6 - $241 3%
Fidelis $6 - $412 3%
Tricare $6 - $7 3%
Blue Shield Highmark $7 - $34 3%
Hamaspik $7 - $327 3%
Medicaid / KanCare $7 - $10 3%
UnitedHealthcare $7 - $221 3%
Aetna $8 - $18 4%
Emblem Health Ghi $8 - $16 4%
Nascentia $8 4%
Emblem $12 - $221 5%
Mvp Commercial $12 - $207 5%
Nascentia Health Options $12 5%
Emblem_Ghi $13 - $221 6%
Empire Plan Nyship $13 - $177 6%
Magnacare $13 - $221 6%
Multiplan $14 - $235 6%
Mvp $15 - $229 7%
Blue Shield $16 - $104 7%
Cigna $24 - $29 11%
Nys Department Of Corrections $38 17%
Mvp Essential Plan $211 94%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43 New Scotland Avenue, Mail Code 34, Albany, NY 12208
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals