CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Ohio State University State Health System

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $244
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Ohio State University State Health System is $244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.09x the Medicare baseline. Located in 410 West 10Th Avenue, Columbus, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$244

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%)
Insurance Median: $244 (109%)
Ins. Median: $244 (109% 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
Osu Health Plan $151 - $244 67%
Ohio Ppo $182 - $218 81%
Aetna $195 - $392 87%
Blue Cross Blue Shield $195 - $624 87%
Medicare (plans) $195 - $210 87%
Medigold $195 87%
Mmo $195 - $644 87%
Molina $195 - $325 87%
Upper Ohio Valley $195 - $321 87%
Odrc $198 89%
Humana $199 - $224 89%
Buckeye Community $201 - $302 90%
Caresource $204 - $302 91%
Healthspan $204 - $234 91%
Cigna $316 141%
Ohiohealth $317 - $365 142%
Lifetrac $331 148%
Frontpath $390 174%
Multiplan $390 174%
Healthsmart $438 196%
United $751 336%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 410 West 10Th Avenue, Columbus, OH 43210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals