CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Glens Falls Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $17
  • Cash Discount Price: $159
  • vs. Medicare Baseline: 0.08x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Glens Falls Hospital is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.08x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.
Cash / Self-Pay
$159

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

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: $159 (71%)
Insurance Median: $17 (8%)
Cash: $159 (71% of Medicare)
Ins. Median: $17 (8% 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
Cdphp $5 - $240 2%
Medicare (plans) $5 - $7 2%
UnitedHealthcare $5 - $269 2%
Emblem Health Ghi $6 - $7 3%
Tricare $6 - $7 3%
Aetna $7 - $243 3%
Blue Cross Blue Shield $7 - $1,715 3%
Fidelis $7 - $1,583 3%
Medicaid / KanCare $7 - $10 3%
Blue Shield $11 - $51 5%
Mvp $15 - $224 7%
Blue Shield Highmark $16 - $18 7%
Cigna $24 - $29 11%
Mvp Commercial $52 23%
Empire Plan Nyship $206 - $2,242 92%
Hamaspik $206 - $1,715 92%
Nascentia Health Options $206 - $1,715 92%
Magnacare $238 - $1,978 106%
Emblem $254 - $2,110 114%
Multiplan $269 - $2,242 120%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Park Street, Glens Falls, NY 12801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals