CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Jefferson Healthcare

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $101
Cash Discount Price: $194
vs. Medicare Baseline: 0.45x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Jefferson Healthcare is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $194. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.45x the Medicare baseline. Located in 834 Sheridan Street, Port Townsend, WA.

Cash / Self-Pay

$194

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $194 (87%)

Insurance Median: $101 (45%)

Cash: $194 (87% of Medicare)

Ins. Median: $101 (45% 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
Chpw Mcaid	$56 - $89	25%
Molina Mcaid	$57 - $91	25%
Amerigroup Mcaid-All Plans	$59 - $94	26%
Coord Care Mcaid Ip/Op Only	$60 - $96	27%
Aetna	$63 - $257	28%
Molina Mcr Adv	$63 - $100	28%
Tricare	$63 - $100	28%
Medicare (plans)	$64 - $102	29%
Chpw Mcr Adv	$68 - $108	30%
Molina Marketplace-All Other Plans	$78 - $125	35%
UnitedHealthcare	$100 - $160	45%
Regence-All Other Plans	$134 - $214	60%
Chpw Commercial-All Other Plans	$152 - $243	68%
Premera-All Plans	$152 - $243	68%
Cigna	$161 - $257	72%
Coord Care Cascade Ip/Op Only	$161 - $257	72%
Coord Care Comm/Exchge-All Other Plans	$161 - $257	72%

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 $194.
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 Jefferson Healthcare 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.