CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Rehabilitation Hospital of Wisconsin

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $98
  • Cash Discount Price: $100
  • vs. Medicare Baseline: 0.44x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Rehabilitation Hospital of Wisconsin is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.44x the Medicare baseline. Located in 1625 Coldwater Creek Dr, Waukesha, WI.
Cash / Self-Pay
$100

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $100 (45%)
Insurance Median: $98 (44%)
Cash: $100 (45% of Medicare)
Ins. Median: $98 (44% 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
Alliance Ppo $56 - $120 25%
Dean Ppo Hmo/Pos $56 - $120 25%
Medica (Under Dean) $56 - $120 25%
UnitedHealthcare $57 - $174 25%
Trilogy Ppo $58 - $174 26%
Wps "Insurance" Ppo $59 - $127 26%
Hps Solutions Ppo $61 - $132 27%
Phcs Savility $61 - $130 27%
Aetna $63 - $174 28%
Health Eos Poc $65 - $139 29%
Coventry/First Health Ppo $66 - $142 30%
Hps (Other) $66 - $142 30%
Health Eos Multiplan $69 - $148 31%
Phcs / Multiplan $74 - $160 33%
All Savers $81 - $174 36%
Blue Cross Blue Shield $81 - $174 36%
Centivo Broad $81 - $174 36%
Centivo Intermediate/Median $81 - $174 36%
Centivo Narrow/Value $81 - $174 36%
Children'S Communty Health Plan(Cchp) $81 - $174 36%
Cigna $81 - $174 36%
Community Care, Inc $81 - $174 36%
Humana $81 - $174 36%
Icare Mcd $81 - $174 36%
Managed Health Services (Mhs) $81 - $174 36%
Medicaid / KanCare $81 - $174 36%
Medicare (plans) $81 - $174 36%
Molina (Fka Care Wisconsin) $81 - $174 36%
Network Health - Aca $81 - $174 36%
Network Health - Commercial $81 - $174 36%
Quartz (Self Funded) / Unity Health Plan (Hmo/Pos) $81 - $174 36%
Security Health Plan - Advocare $81 - $174 36%
Together With Cchp $81 - $174 36%
Unity Health Plan And Unity Quartz(Hmo/Pos) $81 - $174 36%
Va - Primary Only - Authorization Required $81 - $174 36%
Wellcare Mcr $81 - $174 36%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1625 Coldwater Creek Dr, Waukesha, WI 53188
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL