CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Arbor Health Morton Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $161
Cash Discount Price: $213
vs. Medicare Baseline: 0.72x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Arbor Health Morton Hospital is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $213. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.72x the Medicare baseline. Located in 521 Adams Street, Morton, WA.

Cash / Self-Pay

$213

Average discount available for prompt cash payment at this facility.

Insurance Median

$161

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: $213 (95%)

Insurance Median: $161 (72%)

Cash: $213 (95% of Medicare)

Ins. Median: $161 (72% 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
Comm Health Healthy Options	$145 - $150	65%
Kaiser Mcaid	$145 - $150	65%
UnitedHealthcare	$145 - $279	65%
Amerigroup-All Other Plans	$154 - $159	69%
Aetna	$155 - $307	69%
Amerigroup Mcr Adv	$155 - $161	69%
Comm Health Mcr Adv	$155 - $161	69%
Healthnet Mcr Adv - All Plans	$155 - $161	69%
Humana	$155 - $161	69%
Mcr Railroad Mcr Adv - All Plans	$155 - $161	69%
Medicare (plans)	$155 - $161	69%
Premera Hmo Mcr Adv	$155 - $161	69%
Rural Health Mcare - All Plans	$155 - $161	69%
Regence Blue Shield Mcr Adv	$157 - $162	70%
Molina Mcr Adv	$163 - $169	73%
Wellcare Mcr Adv - All Plans	$163 - $169	73%
Molina Marketplace-All Other Plans	$199 - $205	89%
Regence Blue Shield Ump-All Other Plans	$237 - $244	106%
Kaiser Comm-All Other Plans	$265 - $274	118%
Molina Mcaid	$281 - $290	126%
Comm Health Basic Sub - All Other Plans	$287 - $297	128%
Comm Health Pebb	$287 - $297	128%
Premera First-All Other Plans	$304 - $314	136%
Cigna	$314 - $325	140%
First Choice-All Plans	$314 - $325	140%

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 $213.
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 Arbor Health Morton 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.