CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: OHSU Hospital and Clinics

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $191
  • Cash Discount Price: $128
  • vs. Medicare Baseline: 0.85x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at OHSU Hospital and Clinics is $191. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.85x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.
Cash / Self-Pay
$128

Average discount available for prompt cash payment at this facility.

Insurance Median
$191

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: $128 (57%)
Insurance Median: $191 (85%)
Cash: $128 (57% of Medicare)
Ins. Median: $191 (85% 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
Community Health Plan Of Washington $19 - $344 8%
Samaritan Health Plan $54 - $615 24%
Moda $55 - $677 25%
Pacific Source $60 - $527 27%
Coventry First Health $74 - $508 33%
First Choice $75 - $513 34%
Aetna $77 - $528 34%
Health Net Health Plan Of Oregon, Inc. $77 - $524 34%
Providence Health Plan $84 - $575 38%
Cigna $90 - $619 40%
Blue Cross Blue Shield $99 - $654 44%
Care Oregon $99 - $290 44%
Intercommunity Health Network $99 - $197 44%
Kaiser Foundation Hospitals $99 - $572 44%
Medicare (plans) $99 - $393 44%
Molina Exchange $99 - $677 44%
Tuality Health $99 - $443 44%
UnitedHealthcare $99 - $677 44%
Humana $246 - $261 110%
Trillium $246 110%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3181 Sw Sam Jackson Park Road, Portland, OR 97239
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals