CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Montefiore New Rochelle Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $6
Cash Discount Price: $446
vs. Medicare Baseline: 0.03x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Montefiore New Rochelle Hospital is $6. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $446. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.03x the Medicare baseline. Located in 16 Guion Place, New Rochelle, NY.

Cash / Self-Pay

$446

Average discount available for prompt cash payment at this facility.

Insurance Median

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: $446 (199%)

Insurance Median: $6 (3%)

Cash: $446 (199% of Medicare)

Ins. Median: $6 (3% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Amidacare	$3 - $253	1%
Emblem	$3 - $289	1%
Empire	$3 - $241	1%
Fidelis	$3 - $241	1%
Hamaspik	$3 - $260	1%
Medicaid / KanCare	$3	1%
Metroplus	$3 - $313	1%
Molina Healthcare Of Ny Affinity	$3 - $332	1%
Mvp	$3 - $6	1%
UnitedHealthcare	$3 - $241	1%
Vnsny Choice	$3 - $241	1%
Vnsny Select Health	$3	1%
Wellcare	$3 - $245	1%
Healthfirst	$9 - $241	4%
Villagecaremax	$241	108%
Centerlight	$248	111%
Partners_Health_Plan	$253	113%
Humana	$265	118%
Centivo	$446	199%
Cigna	$508 - $541	227%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $446.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Montefiore New Rochelle Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.