CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Uh Regional Hospitals

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $179
Cash Discount Price: $191
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Uh Regional Hospitals is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.80x the Medicare baseline. Located in 13207 Ravenna Road, Chardon, OH.

Cash / Self-Pay

$191

Average discount available for prompt cash payment at this facility.

Insurance Median

$179

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: $191 (85%)

Insurance Median: $179 (80%)

Cash: $191 (85% of Medicare)

Ins. Median: $179 (80% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medical Mutual Of Ohio	$66 - $189	30%
University Health Employee Plan (Contigo)	$102	46%
Amish Aid Community Plan	$117	52%
Amish Church Fund And Workers Aid Plan	$117	52%
Buckeye Plain Ministries	$117	52%
Clarity	$122	55%
Jp Farley	$122	55%
Christian Healthcare Ministries	$128	57%
Immergrun	$128	57%
Sunrise Plan Communities	$128	57%
Blue Cross Blue Shield	$130 - $189	58%
Summacare	$130 - $189	58%
UnitedHealthcare	$135 - $189	60%
Aultcare	$140	63%
Cigna	$143 - $189	64%
Aetna	$156 - $336	70%
Healthsmart	$166	74%
Ohio Health Choice	$166 - $230	74%
The Health Plan	$168 - $189	75%
Devoted Health	$189	84%
Humana	$189	84%
Molina	$189	84%
Primetime Health Plan	$189	84%
Wellcare By Allwell	$189	84%
Paramount	$194	87%
Perennial Advantage Of Ohio	$198	89%
Valor Health Plans	$198	89%
Beech Street	$204 - $230	91%
Ohio Preferred Network	$204 - $230	91%
First Health	$212	95%
Century Health Network	$217	97%
Private Healthcare System	$219	98%
Configurenet	$230	103%
Fortified Provider Network	$230	103%
Multiplan	$230	103%
Ambetter / Centene	$339	152%
Caresource	$339	152%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $191.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Uh Regional Hospitals is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.