CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: East Liverpool City Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $206
  • Cash Discount Price: $206
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at East Liverpool City Hospital is $206. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $206. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.92x the Medicare baseline. Located in 425 West 5Th Street, East Liverpool, OH.
Cash / Self-Pay
$206

Average discount available for prompt cash payment at this facility.

Insurance Median
$206

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: $206 (92%)
Insurance Median: $206 (92%)
Cash: $206 (92% of Medicare)
Ins. Median: $206 (92% 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
Buckeye Community Health Plan $87 - $330 39%
Medicaid / KanCare $87 39%
Molina $87 - $299 39%
Standard Eapg Logic $87 39%
Care Source $89 - $299 40%
Blue Cross Blue Shield $90 - $206 40%
Paramount $90 40%
Amerihealth Caritas $92 41%
UnitedHealthcare $92 - $206 41%
Health America $206 92%
Medical Mutual Of Oh $206 92%
Medicare (plans) $206 92%
Tricare $206 92%
Devoted Health $216 97%
Communicare $221 99%
Valor Health Plan $221 99%
Perennial $227 101%
Naphcare $247 110%
Employer Direct Healthcare $289 129%
Three Rivers $299 134%
Provider Select $306 137%
Worker Compensation $308 138%
Multiplan (Fka Private Healthcare Systems) $309 138%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 425 West 5Th Street, East Liverpool, OH 43920
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals