CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Union Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $111
  • Cash Discount Price: $528
  • vs. Medicare Baseline: 0.50x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Union Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $528. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.50x the Medicare baseline. Located in 659 Boulevard, Dover, OH.
Cash / Self-Pay
$528

Average discount available for prompt cash payment at this facility.

Insurance Median
$111

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: $528 (236%)
Insurance Median: $111 (50%)
Cash: $528 (236% of Medicare)
Ins. Median: $111 (50% 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
Summacare $5 - $380 2%
Aetna $7 - $813 3%
Aultcare $7 - $366 3%
Blue Cross Blue Shield $7 - $433 3%
Cigna $7 - $366 3%
Communicare $7 - $197 3%
Humana $7 - $188 3%
Mmo $7 - $528 3%
The Health Plan $7 - $699 3%
United $7 - $402 3%
Valor $7 - $188 3%
Cc Ehp $8 - $606 4%
Perennial Health $8 - $203 4%
Pphp $8 - $207 4%
Zing Health $8 - $207 4%
Buckeye $11 - $57 5%
Caresource $11 - $57 5%
Molina $11 - $60 5%
Amerihealth $12 - $63 5%
Oscar $38 - $313 17%
Ohcp $56 - $395 25%
Omas $72 - $406 32%
Healthsmart $79 - $447 35%
Phphi $86 - $488 38%
Upmc $86 - $488 38%
Gms $100 - $569 45%
Consociate Health $107 - $610 48%
Multiplan $129 - $732 58%
UnitedHealthcare $184 - $188 82%
Devoted Health $188 84%
Amish Community Aid Plan $366 - $406 164%
Ohio Healthy $439 196%
Php $488 218%
Medical Benefit Corp $569 254%
Frontpath $732 327%
Managed Care Services $732 327%
Tertiary Care Network $732 327%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 659 Boulevard, Dover, OH 44622
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals