CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Saratoga Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $13
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 0.06x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Saratoga Hospital is $13. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.06x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$13

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: $27 (12%)
Insurance Median: $13 (6%)
Cash: $27 (12% of Medicare)
Ins. Median: $13 (6% 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 - $241 2%
Fidelis $5 - $241 2%
Medicare (plans) $5 - $7 2%
Blue Cross Blue Shield $6 - $370 3%
Tricare $6 - $7 3%
Aetna $7 - $18 3%
Emblem Health Ghi $7 - $8 3%
Hamaspik $7 - $327 3%
Medicaid / KanCare $7 - $10 3%
UnitedHealthcare $7 - $475 3%
Emblem $12 - $241 5%
Nascentia Health Options $12 5%
Mvp $15 - $29 7%
Blue Shield Highmark $16 - $18 7%
Cigna $24 - $29 11%
Empire Plan Nyship $32 - $370 14%
Mvp Commercial $37 - $396 17%
Multiplan $40 - $449 18%
Magnacare $48 - $502 21%
Blue Shield $51 - $243 23%
Mvp Essential Plan $101 - $202 45%
Mvp Govt Programs $101 45%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 211 Church Street, Saratoga Springs, NY 12866
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals