CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: St John's Episcopal Hospital at South Shore

Billing Code: 94640 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$142

about 0.6× the $224 Medicare rate · typically $27–$269

modeled estimate · not a bill or quote

What this hospital charges insurers

$273

Well above the fair price

about $131 over the fair price · 1.2× Medicare

Medicare pays $224 Fair price $142 This hospital $273 Cash price $749 Hospital's list price $749

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $43 Priciest $273

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Breathing treatment (nebulizer) is about $142 (about 0.6× the $224 Medicare rate). St John's Episcopal Hospital at South Shore charges insurers about $273, or about $749 in cash — well above the fair price. Located in Far Rockaway, NY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $142. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$130 - $273	58%
Blue Cross Blue Shieldmajor	$273 - $410	122%
Aetnamajor	$273 - $383	122%
Humanamajor	$273	122%
Fidelis Care	$273	122%
Molina	$301	135%
WellCare	$273	122%
+ 11 smaller / regional plans	$34 - $615

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 749), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 94640.

Insurance Before you use insurance

Call your insurance company to confirm St John's Episcopal Hospital at South Shore is in-network.
Ask your insurer whether prior approval is required for CPT code 94640.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St John's Episcopal Hospital at South Shore

Compare: Breathing treatment (nebulizer) at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.