CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $97
  • Cash Discount Price: $76
  • vs. Medicare Baseline: 0.43x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Cincinnati Children's Hospital Medical Center is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.43x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$76

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $76 (34%)
Insurance Median: $97 (43%)
Cash: $76 (34% of Medicare)
Ins. Median: $97 (43% 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
Blue Cross Blue Shield $4 - $294 2%
Caresource_In $4 - $9 2%
Aetna $8 - $284 4%
Mhs_In $8 4%
Humana $9 - $102 4%
United_Health_Care_Ky $9 - $79 4%
Wellcare_Ky $9 - $79 4%
Amerihealth_Caritas_Oh $10 - $105 4%
Caresource_Oh $10 - $97 4%
Molina_Oh $10 - $107 4%
Buckeye_Oh $11 - $112 5%
Passport_Ky $12 - $78 5%
United_Health_Care_Oh $12 - $102 5%
Caresource_Oh_Insurance $26 - $144 12%
Medical_Mutual_Of_Ohio_Insurance $28 - $284 13%
Parkview_Signature_Care_Insurance $32 - $233 14%
Margaret_Mary_Health_Insurance $34 - $233 15%
Point_Comfort_Insurance $34 - $194 15%
Cigna $35 - $284 16%
Beechstreet_Insurance $42 - $293 19%
Health_Ohio_Network_Insurance $42 - $284 19%
Evolutions_Health_Care_Systems $47 - $299 21%
Galaxy_Health_Insurance $47 - $299 21%
Custom_Design_Benefits_Insurance $49 - $284 22%
First_Health_Group_Insurance $49 - $293 22%
Health_Link_Insurance $49 - $293 22%
Health_Smart_Preferred_Insurance $49 - $284 22%
Medical_Benefit_Administrators_Insurance $49 - $284 22%
Ohio_Health_Choice_Insurance $49 - $284 22%
Private_Health_Care_Systems_Insurance $52 - $287 23%
United_Health_Care_Insurance $52 - $268 23%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens