CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Medical West, An Affiliate of UAB Health System

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $141
Cash Discount Price: $125
vs. Medicare Baseline: 0.63x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Medical West, An Affiliate of UAB Health System is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.63x the Medicare baseline. Located in 995 9Th Avenue Southwest, Bessemer, AL.

Cash / Self-Pay

$125

Average discount available for prompt cash payment at this facility.

Insurance Median

$141

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: $125 (56%)

Insurance Median: $141 (63%)

Cash: $125 (56% of Medicare)

Ins. Median: $141 (63% 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
Cigna	$12 - $213	5%
Viva	$24 - $230	11%
Aetna	$27 - $200	12%
Phcs	$29 - $159	13%
Beech Street	$30 - $159	13%
One Health Plan	$31 - $148	14%
Geha	$33 - $159	15%
Healthchoice	$33 - $159	15%
Alamed	$37 - $178	17%
Construction Claims Management	$39 - $184	17%
Corvel	$39 - $204	17%
Multiplan	$39 - $186	17%
Novanet	$40 - $190	18%
Humana	$41 - $212	18%
Department Of Labor	$42 - $197	19%
Heritage Summit Health	$42 - $197	19%
Pnoa	$43 - $204	19%
Three Rivers	$43 - $204	19%
Blue Cross Blue Shield	$198	89%
Cooper Green	$200	89%
Jefferson County Sheriff	$200	89%
Triwest	$200	89%
United Mine Workers	$200	89%
UnitedHealthcare	$200 - $636	89%
Ambetter / Centene	$275	123%

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 $125.
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 Medical West, An Affiliate of UAB Health System 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.