CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Elmhurst Hospital Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $129
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.58x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Elmhurst Hospital Center is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.58x the Medicare baseline. Located in 79-01 Broadway, Elmhurst, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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%)
Insurance Median: $129 (58%)
Ins. Median: $129 (58% 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
Healthfirst $7 - $232 3%
Emblem $9 - $345 4%
Wellcare $10 - $259 4%
Fidelis $13 - $342 6%
Aetna $16 - $302 7%
Blue Cross Blue Shield $60 - $345 27%
Oxford $69 - $76 31%
United $83 - $129 37%
Metroplus $95 - $232 42%
Amidacare $103 46%
Carelon $103 - $280 46%
Senior Whole Health $103 46%
United Behavioral Health $103 - $113 46%
Affinity $105 - $232 47%
Carelon (Amida Care) $105 47%
Vnsny $105 - $366 47%
Centerlight $216 97%
Oscar $237 - $361 106%
Cigna $241 108%
Elderplan $241 - $280 108%
Vaccn $241 108%
Centers Plan For Healthy Living $250 112%
Magnacare $323 144%
Multiplan $345 154%
Local 1199 $366 164%
Villagecare Max $366 164%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 79-01 Broadway, Elmhurst, NY 11373
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals