CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Hillcrest Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $324
  • Cash Discount Price: $528
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Hillcrest Hospital is $324. 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 1.45x the Medicare baseline. Located in 6780 Mayfield Road, Mayfield Heights, OH.
Cash / Self-Pay
$528

Average discount available for prompt cash payment at this facility.

Insurance Median
$324

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: $324 (145%)
Cash: $528 (236% of Medicare)
Ins. Median: $324 (145% 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 $55 - $504 25%
Paramount $60 27%
Blue Cross Blue Shield $61 - $521 27%
Buckeye $61 27%
Molina $61 27%
Caresource $62 28%
United $62 - $2,244 28%
Amerihealth $64 29%
The Health Plan $185 - $488 83%
Aetna $189 - $813 84%
Devoted Health $189 84%
Humana $189 - $691 84%
Mmo $189 - $480 84%
Summacare $189 - $302 84%
Upmc $189 - $488 84%
Valor $189 84%
Cigna $194 - $389 87%
Communicare $198 89%
Perennial Health $204 91%
Pphp $207 93%
Oscar $245 - $313 110%
Cc Ehp $324 - $329 145%
Aultcare $341 152%
Amish Community Aid Plan $366 - $406 164%
Ohcp $395 177%
Omas $406 181%
Ohio Healthy $439 196%
Healthsmart $447 200%
Php $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: 6780 Mayfield Road, Mayfield Heights, OH 44124
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals