CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Newport Community Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $391
Cash Discount Price: $507
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Newport Community Hospital is $391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $507. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.75x the Medicare baseline. Located in 714 West Pine Street, Newport, WA.

Cash / Self-Pay

$507

Average discount available for prompt cash payment at this facility.

Insurance Median

$391

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: $507 (227%)

Insurance Median: $391 (175%)

Cash: $507 (227% of Medicare)

Ins. Median: $391 (175% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Pacificsource	$219 - $277	98%
Bcidaho	$221 - $481	99%
Molina	$221 - $424	99%
Wellcare	$221 - $280	99%
UnitedHealthcare	$230 - $538	103%
Wellpoint	$236 - $299	105%
Aetna	$349 - $441	156%
Premera	$380 - $481	170%
Cigna	$402 - $509	180%
Multiplan	$411 - $521	184%
Asuris	$425 - $538	190%
Regence_Wa	$425 - $538	190%
Firstchoice	$429 - $543	192%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $507.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Newport Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.