CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Columbia Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $12
  • Cash Discount Price: $122
  • vs. Medicare Baseline: 0.05x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Columbia Memorial Hospital is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.05x the Medicare baseline. Located in 71 Prospect Avenue, Hudson, NY.
Cash / Self-Pay
$122

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $122 (55%)
Insurance Median: $12 (5%)
Cash: $122 (55% of Medicare)
Ins. Median: $12 (5% 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
UnitedHealthcare $3 - $257 1%
Medicare (plans) $6 - $9 3%
Mvp $6 - $206 3%
Blue Cross Blue Shield $7 - $364 3%
Medicaid / KanCare $7 - $98 3%
Tricare $7 - $9 3%
Fidelis $8 - $253 4%
Hamaspik $8 - $134 4%
Aetna $9 - $308 4%
Cdphp $9 - $241 4%
Emblem $12 - $257 5%
Emblem Health Ghi $12 5%
Blue Shield Highmark $16 - $18 7%
Cigna $24 11%
Mvp Commercial $31 14%
Empire Plan Nyship $36 - $364 16%
Magnacare $46 - $330 21%
Multiplan $54 - $385 24%
Herrington Diversified Pdh $60 - $361 27%
Blue Shield $66 - $350 30%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Prospect Avenue, Hudson, NY 12534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals