CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Arthur G James Cancer Hospital and Research Institute

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $282
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Arthur G James Cancer Hospital and Research Institute is $282. 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 1.26x the Medicare baseline. Located in 460 W 10Th Ave, Columbus, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$282

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: $282 (126%)
Ins. Median: $282 (126% 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
Healthspan $107 - $5,413 48%
Medigold $107 48%
Upper Ohio Valley $107 - $5,413 48%
Medicare (plans) $108 - $5,467 48%
Humana $109 - $5,521 49%
Medicaid / KanCare $123 - $169 55%
Aetna $129 - $5,388 58%
United $136 - $443 61%
Caresource $161 - $240 72%
Mmo $161 - $411 72%
Molina $161 - $5,388 72%
Odrc $169 - $198 76%
Blue Cross Blue Shield $179 - $462 80%
Buckeye Community $180 - $239 80%
Amerihealth $181 - $262 81%
Osu Health Plan $222 - $322 99%
Lifetrac $317 - $331 142%
Ohio Ppo $320 143%
Ohiohealth $351 - $356 157%
Cigna $353 - $365 158%
Frontpath $390 174%
Healthsmart $438 196%
Multiplan $453 202%
Ohio Dept Of Health $4,289 1917%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 460 W 10Th Ave, Columbus, OH 43210
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL