CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Rainbow Babies and Childrens Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $174
  • Cash Discount Price: $194
  • vs. Medicare Baseline: 0.78x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Rainbow Babies and Childrens Hospital is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $194. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.78x the Medicare baseline. Located in 11100 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$194

Average discount available for prompt cash payment at this facility.

Insurance Median
$174

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: $194 (87%)
Insurance Median: $174 (78%)
Cash: $194 (87% of Medicare)
Ins. Median: $174 (78% 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
Medical Mutual Of Ohio $86 - $205 38%
University Health Employee Plan (Contigo) $104 - $130 46%
Amish Aid Community Plan $130 58%
Amish Church Fund And Workers Aid Plan $130 58%
Buckeye Plain Ministries $130 58%
Christian Healthcare Ministries $130 58%
Sunrise Plain Communities $130 58%
Blue Cross Blue Shield $137 - $189 61%
Caresource $140 63%
Aetna $145 - $206 65%
Ambetter / Centene $145 65%
Cigna $145 - $189 65%
Jp Farley $145 - $155 65%
Immergrun $155 69%
UnitedHealthcare $160 - $189 72%
Aultcare $163 - $171 73%
Healthsmart $168 75%
Ohio Health Choice $168 - $233 75%
The Health Plan $168 - $189 75%
Health Ohio Network $174 78%
Summacare $176 - $189 79%
Clarity $181 81%
Enterprise Group Planning $181 81%
Medical Mutual Traditional/Health Ohio $181 81%
Devoted Health $189 84%
Humana $189 84%
Molina $189 84%
Primetime Health Plan $189 84%
Wellcare By Allwell $189 84%
Paramount $194 87%
Perennial Advantage Of Ohio $198 89%
Valor Health Plans $198 89%
Beech Street $207 - $233 93%
Ohio Preferred Network $207 - $233 93%
Century Health Network $220 98%
First Health $220 98%
Private Healthcare System $223 100%
Configurenet $233 104%
Fortified Provider Network $233 104%
Multiplan $233 104%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11100 Euclid Avenue, Cleveland, OH 44106
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens