CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Suny/Stony Brook University Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $354
  • Cash Discount Price: $351
  • vs. Medicare Baseline: 1.58x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Suny/Stony Brook University Hospital is $354. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $351. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.58x the Medicare baseline. Located in Health Sciences Center SUNY, Stony Brook, NY.
Cash / Self-Pay
$351

Average discount available for prompt cash payment at this facility.

Insurance Median
$354

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: $351 (157%)
Insurance Median: $354 (158%)
Cash: $351 (157% of Medicare)
Ins. Median: $354 (158% 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 $165 74%
Healthfirst Essential Plan 1/2 $250 112%
Healthfirst Essential Plan 3/4 $250 112%
Aetna $272 - $33,011 122%
Blue Cross Blue Shield $272 122%
Elderplan $272 122%
Fidelis Care $272 122%
Healthfirst Health Plan $272 122%
UnitedHealthcare $272 - $4,255 122%
Emblemhealth Hip Of Ny $277 - $2,110 124%
Agewell New York $299 134%
Centerlight $354 158%
Partners Health Plan $354 158%
Emblemhealth Hip Of Ny Select Care $1,584 708%
Cigna $1,789 800%
Emblemhealth Ghi $1,838 822%
Brighton All Payer $2,422 1083%
Oxford Freedom And Liberty $2,762 1235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Health Sciences Center SUNY, Stony Brook, NY 11794
  • CMS Rating: ★★★★★
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals