CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Long Island Community Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $203
  • Cash Discount Price: $52
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Long Island Community Hospital is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.91x the Medicare baseline. Located in 101 Hospital Road, Patchogue, NY.
Cash / Self-Pay
$52

Average discount available for prompt cash payment at this facility.

Insurance Median
$203

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: $52 (23%)
Insurance Median: $203 (91%)
Cash: $52 (23% of Medicare)
Ins. Median: $203 (91% 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
Cigna $100 - $203 45%
Local 1199 $102 46%
Blue Cross Blue Shield $127 - $203 57%
Magellan $132 59%
Multiplan $132 59%
Oscar Health Exchange $138 62%
Coventry $150 67%
Longevity Health $163 73%
Galaxy $183 82%
Aarp $203 91%
Aetna $203 91%
Beacon Health Options $203 91%
Centerlight $203 91%
Emblem Ghi $203 91%
Fidelis $203 91%
Humana $203 91%
Integra $203 91%
Medicare (plans) $203 91%
UnitedHealthcare $203 91%
Agewell $210 94%
Elderplan Inc. $224 100%
Wellcare $224 100%
Nexus Nyu $398 178%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 Hospital Road, Patchogue, NY 11772
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals