CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Adventist Health Portland

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $401
  • Cash Discount Price: $197
  • vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Adventist Health Portland is $401. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $197. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.79x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$197

Average discount available for prompt cash payment at this facility.

Insurance Median
$401

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: $197 (88%)
Insurance Median: $401 (179%)
Cash: $197 (88% of Medicare)
Ins. Median: $401 (179% 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
Healthcare Resources - All Plans $57 - $166 25%
Workers Comp $88 - $255 39%
Bc Premera First - All Plans $127 - $369 57%
Healthnet Hmo/Pos - All Other Plans $145 - $420 65%
Healthnet Epo/Pos/Ppo $146 - $424 65%
UnitedHealthcare $152 - $443 68%
Worldventure - All Plans $152 - $443 68%
Providence Hp - All Plans $165 - $480 74%
Regence Preferred Mcr Adv $166 - $482 74%
Pacific Source Comm - All Plans $168 - $487 75%
Cigna $171 - $498 76%
First Choice - All Plans $176 - $511 79%
Multiplan - All Plans $190 - $554 85%
Phcs - All Plans $190 - $554 85%
Regence Mcr Adv $193 - $561 86%
Ods - All Plans $195 87%
Aetna $199 - $577 89%
First Health-Coventry - All Plans $203 - $590 91%
Care Oregon - All Plans $207 93%
National Provider Network - All Plans $224 - $649 100%
Health Payors Organization Ltd- All Plans $229 - $664 102%
Kaiser Mcr Adv $243 109%
Humana $248 - $258 111%
Moda Mcr Adv $258 115%
Healthnet Mcr Adv $280 125%
Ah Employee Health Plan - All Plans $438 196%
Regence Ohsu Plus $452 202%
Moda Ohsu Ppo/Epo/Hmc $457 - $1,328 204%
Moda Conn Oebb/Syn Pebb $487 218%
Regence - All Other Plans $502 224%
Moda Affinity - All Other Plans $560 250%
Kaiser - All Other Plans $635 284%
Moda Select $762 341%
Moda Connexus $862 385%
Moda Synergy $912 408%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals