CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $190
  • Cash Discount Price: $163
  • vs. Medicare Baseline: 0.85x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at University of Wi Hospitals & Clinics Authority is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.85x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.
Cash / Self-Pay
$163

Average discount available for prompt cash payment at this facility.

Insurance Median
$190

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: $163 (73%)
Insurance Median: $190 (85%)
Cash: $163 (73% of Medicare)
Ins. Median: $190 (85% 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
Blue Cross Blue Shield $100 - $295 45%
Alliance_Premier_Network $118 - $149 53%
Mercycare $122 - $154 55%
Triology $125 - $190 56%
Security_Health_Plan $133 - $197 59%
Employer'S_Coalition_On_Health $135 - $239 60%
Alliance $138 - $175 62%
Hfn $140 - $239 63%
United_Healthcare $141 - $264 63%
Beloit_Health_System $143 - $180 64%
Aspirus_Health_Plan $144 - $182 64%
Cigna $148 - $187 66%
Health_Partners_Insurance $150 - $190 67%
Health_Payment_Systems $151 - $191 67%
UnitedHealthcare $154 - $224 69%
Dean_Health_Plan $157 - $199 70%
Medical_Associates $162 - $205 72%
Wps $170 - $237 76%
Employers_Healthcare_Coalition_Of_Wi $172 - $218 77%
Aetna $175 - $249 78%
Aspirus_Network_Inc $189 - $239 84%
Chorus_Community $197 - $249 88%
Ghc_Eau_Claire_Health_Plan $197 - $249 88%
Multiplan $197 - $286 88%
Sheybogan_Employers_Health_Network $197 - $249 88%
Coventry $209 - $264 93%
Dean_Care $209 - $264 93%
Healthsmart $216 - $274 97%
Humana $224 100%
Medicare (plans) $224 - $228 100%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Highland Avenue, Madison, WI 53792
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals