Breathing treatment (nebulizer)
Facility: Kenmore Mercy Hospital
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $8
- Cash Discount Price: $388
- vs. Medicare Baseline: 0.04x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Excellus Rochester McD [350117] | $3 - $7 | 1% |
| Tuscarora Nation [550120] | $3 - $7 | 1% |
| Crime Victims [100176] | $3 - $7 | 1% |
| Beacon Essential [350122] | $3 - $9 | 1% |
| Medicaid / KanCare | $3 - $159 | 1% |
| UnitedHealthcare | $3 - $19 | 1% |
| Univera Healthcare Essential [100170] | $3 - $7 | 1% |
| Amerigroup [350102] | $3 - $7 | 1% |
| Blue Cross Blue Shield | $3 - $18 | 1% |
| Fidelis Essential [100163] | $7 - $8 | 3% |
| Univera Healthcare [100169] | $7 - $11 | 3% |
| Vna Option Mltc [350110] | $7 | 3% |
| Independent Health Essential [100166] | $7 - $191 | 3% |
| VA Veterans Affairs [700001] | $7 | 3% |
| Molina Essential [100167] | $7 - $17 | 3% |
| Medicare (plans) | $7 - $231 | 3% |
| Champ VA [700002] | $8 | 4% |
| Tricare | $8 | 4% |
| Hospice [550001] | $8 | 4% |
| Cigna | $8 - $11 | 4% |
| Aetna | $8 | 4% |
| Humana | $8 | 4% |
| Fidelis Dual Advantage [450120] | $8 | 4% |
| Seneca Nation [450119] | $8 | 4% |
| Covid19 Hrsa [45013] | $8 | 4% |
| Ghi [100153] | $8 | 4% |
| Wellcare [450129] | $8 | 4% |
| Wellcare Fidelis Dual [450451] | $8 | 4% |
| Catholic Health Life Pace [400005] | $8 | 4% |
| Fallon Health [450115] | $8 | 4% |
| Fidelis Exchange [100164] | $9 | 4% |
| Beacon Health Options [100023] | $9 | 4% |
| Iha First Choice [800001] | $9 - $307 | 4% |
| Independent Health [100165] | $9 - $383 | 4% |
| UPMC Health Plan [100181] | $14 | 6% |
| Mvp Healthcare [100168] | $21 | 9% |
| No Fault [114001] | $32 | 14% |
| Federal Workers Compensation [500100] | $32 | 14% |