CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Bellevue Hospital Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $123
  • Cash Discount Price: $247
  • vs. Medicare Baseline: 0.55x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Bellevue Hospital Center is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $247. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.55x the Medicare baseline. Located in 462 First Avenue, New York, NY.
Cash / Self-Pay
$247

Average discount available for prompt cash payment at this facility.

Insurance Median
$123

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: $247 (110%)
Insurance Median: $123 (55%)
Cash: $247 (110% of Medicare)
Ins. Median: $123 (55% 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 $5 - $274 2%
Affinity $8 - $274 4%
Blue Cross Blue Shield $9 - $380 4%
Centerlight $9 - $241 4%
Elderplan $9 - $309 4%
Emblem $9 - $380 4%
Fidelis $9 - $342 4%
Wellcare $9 - $285 4%
Centers Plan For Healthy Living $10 - $250 4%
Hamaspik $10 4%
Oscar $12 - $361 5%
Aetna $16 - $332 7%
Local 1199 $34 - $403 15%
Oxford $69 - $253 31%
United $83 - $253 37%
Metroplus $114 - $279 51%
Amidacare $122 55%
Carelon $122 - $309 55%
Senior Whole Health $122 55%
United Behavioral Health $122 - $134 55%
Carelon (Amida Care) $124 55%
Vnsny $124 - $403 55%
Cigna $241 108%
Vaccn $241 108%
Magnacare $356 159%
Villagecare Max $370 - $403 165%
Multiplan $380 170%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 462 First Avenue, New York, NY 10016
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals