CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Hillsboro Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $243
  • Cash Discount Price: $165
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Hillsboro Medical Center is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $165. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.09x the Medicare baseline. Located in 335 Se 8Th Avenue, Hillsboro, OR.
Cash / Self-Pay
$165

Average discount available for prompt cash payment at this facility.

Insurance Median
$243

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: $165 (74%)
Insurance Median: $243 (109%)
Cash: $165 (74% of Medicare)
Ins. Median: $243 (109% 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
Pacific Source $90 - $501 40%
Providence Health Plan $92 - $509 41%
Health Net Health Plan Of Oregon, Inc. $93 - $517 42%
First Choice $113 - $626 51%
Coventry First Health $120 - $666 54%
Aetna $127 - $705 57%
Blue Cross Blue Shield $141 - $620 63%
Care Oregon $141 - $287 63%
Cigna $141 - $504 63%
Community Health Plan Of Washington $141 - $783 63%
Kaiser Foundation Hospitals $141 - $713 63%
Medicare (plans) $141 - $287 63%
Moda $141 - $783 63%
Molina Exchange $141 - $783 63%
Tuality Health $141 - $438 63%
UnitedHealthcare $141 - $783 63%
Intercommunity Health Network $190 85%
Samaritan Health Plan $243 109%
Trillium $243 109%
Humana $251 - $258 112%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 335 Se 8Th Avenue, Hillsboro, OR 97123
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals