CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Montefiore St Luke's Cornwall

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $273
  • Cash Discount Price: $273
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Montefiore St Luke's Cornwall is $273. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $273. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.22x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.
Cash / Self-Pay
$273

Average discount available for prompt cash payment at this facility.

Insurance Median
$273

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: $273 (122%)
Insurance Median: $273 (122%)
Cash: $273 (122% of Medicare)
Ins. Median: $273 (122% 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
Affinity $3 - $287 1%
Emblem $3 - $1,728 1%
Healthfirst $3 - $273 1%
Medicaid / KanCare $3 1%
Blue Cross Blue Shield $185 - $369 83%
Fidelis $219 - $317 98%
Mediblue $265 118%
Aetna $271 121%
Cdphp $273 122%
Hudson Valley $273 122%
Oscar $273 - $346 122%
Point Comfort $273 122%
UnitedHealthcare $273 - $473 122%
Villagecaremax $273 122%
Vnsny Choice $273 122%
Centerlight $282 126%
Wellcare $282 126%
Cigna $294 - $327 131%
Hamaspik $295 132%
Humana $301 135%
Centivo $323 144%
Northwell $333 - $735 149%
Magnacare $385 172%
American Postal Workers $473 211%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 70 Dubois Street, Newburgh, NY 12550
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals