CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Aurora Medical Ctr Washington County

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $117
Cash Discount Price: $89
vs. Medicare Baseline: 0.52x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Aurora Medical Ctr Washington County is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.52x the Medicare baseline. Located in 1032 E Sumner St, Hartford, WI.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $89 (40%)

Insurance Median: $117 (52%)

Cash: $89 (40% of Medicare)

Ins. Median: $117 (52% 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
Centivo	$85 - $139	38%
Everpointe Elite	$85 - $92	38%
Hs Technology	$85 - $92	38%
Aetna	$94 - $153	42%
Quartz One	$94 - $102	42%
UnitedHealthcare	$101 - $280	45%
Aurora Caregiver	$102 - $111	46%
Blue Cross Blue Shield	$102 - $157	46%
Common Ground	$102 - $111	46%
Health Eos Plus	$102 - $111	46%
Healthpartners	$102 - $139	46%
Molina Exchange	$102 - $111	46%
Quartz Group	$102 - $111	46%
Wisconsin Physician Service	$105 - $120	47%
Health Payment Systems	$110 - $120	49%
Trilogy	$119 - $130	53%
Cigna	$128 - $157	57%
Health Eos	$136 - $148	61%

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 $89.
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 Aurora Medical Ctr Washington County 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.