CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Marymount Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $358
  • Cash Discount Price: $528
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Marymount Hospital is $358. 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 1.60x the Medicare baseline. Located in 12300 McCracken Road, Garfield Heights, OH.
Cash / Self-Pay
$528

Average discount available for prompt cash payment at this facility.

Insurance Median
$358

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: $358 (160%)
Cash: $528 (236% of Medicare)
Ins. Median: $358 (160% 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
UnitedHealthcare $50 - $504 22%
Paramount $54 24%
Blue Cross Blue Shield $55 - $650 25%
Buckeye $55 25%
Molina $55 25%
United Bh $55 25%
Caresource $56 25%
United $56 - $498 25%
Amerihealth $57 25%
Aetna $189 - $813 84%
Devoted Health $189 84%
Humana $189 - $691 84%
Mmo $189 - $488 84%
Summacare $189 - $299 84%
The Health Plan $189 - $488 84%
Upmc $189 - $488 84%
Valor $189 84%
Cigna $194 - $650 87%
Communicare $198 89%
Perennial Health $204 91%
Pphp $207 93%
Zing Health $207 93%
Oscar $245 - $313 110%
Cc Ehp $324 - $329 145%
Aultcare $350 156%
Amish Community Aid Plan $366 - $406 164%
Ohcp $395 177%
Omas $406 181%
Ohio Healthy $439 196%
Healthsmart $447 200%
Php $488 218%
Phphi $488 218%
Gms $569 254%
Medical Benefit Corp $569 254%
Quality Care Partners $569 254%
Consociate Health $610 273%
Frontpath $732 327%
Managed Care Services $732 327%
Multiplan $732 327%
Tertiary Care Network $732 327%
Three Rivers $732 327%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12300 McCracken Road, Garfield Heights, OH 44125
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals