CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Door County Medical Center

Billing Code: 94640 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$125

about 0.6× the $224 Medicare rate · typically $17–$371

modeled estimate · not a bill or quote

What this hospital charges insurers

$120

About the fair price

about $5 under the fair price · 0.5× Medicare

Medicare pays $224 Fair price $125 This hospital $120 Cash price $202 Hospital's list price $270

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $22 Priciest $120

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Breathing treatment (nebulizer) is about $125 (about 0.6× the $224 Medicare rate). Door County Medical Center charges insurers about $120, or about $202 in cash — about the fair price. Located in Sturgeon Bay, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$119 - $850	53%
Blue Cross Blue Shieldmajor	$119 - $649	53%
Aetnamajor	$120 - $664	54%
Cignamajor	$239 - $314	107%
Humanamajor	$119 - $347	53%
HealthPartners	$118	53%
Molina	$247	110%
+ 3 smaller / regional plans	$181 - $581

Government programs also on file: Medicare, Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 202), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 94640.

Insurance Before you use insurance

Call your insurance company to confirm Door County Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 94640.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Door County Medical Center

Compare: Breathing treatment (nebulizer) at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.