CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Aurora St Lukes Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $94
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 0.42x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Aurora St Lukes Medical Center is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.42x the Medicare baseline. Located in 2900 W Oklahoma Ave, Milwaukee, WI.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$94

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: $66 (30%)
Insurance Median: $94 (42%)
Cash: $66 (30% of Medicare)
Ins. Median: $94 (42% 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
Everpointe Elite $48 - $85 21%
Hs Technology $48 - $85 21%
Aetna $51 - $140 23%
Quartz One $52 - $94 23%
Aurora Caregiver $57 - $102 25%
Blue Cross Blue Shield $57 - $144 25%
Common Ground $57 - $102 25%
Health Eos Plus $57 - $102 25%
Healthpartners $57 - $128 25%
Molina Exchange $57 - $102 25%
Quartz Group $57 - $102 25%
Wisconsin Physician Service $59 - $110 26%
Health Payment Systems $62 - $110 28%
Trilogy $66 - $119 30%
Centivo $71 - $85 32%
Cigna $71 - $144 32%
Health Eos $76 - $136 34%
UnitedHealthcare $80 - $280 36%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2900 W Oklahoma Ave, Milwaukee, WI 53215
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals