CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Healthone Mountain Ridge

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $172
Cash Discount Price: $326
vs. Medicare Baseline: 0.77x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Healthone Mountain Ridge is $172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $326. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.77x the Medicare baseline. Located in 9191 Grant St, Thornton, CO.

Cash / Self-Pay

$326

Average discount available for prompt cash payment at this facility.

Insurance Median

$172

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: $326 (146%)

Insurance Median: $172 (77%)

Cash: $326 (146% of Medicare)

Ins. Median: $172 (77% 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
Vail Health	$49 - $50	22%
Kaiser	$60 - $116	27%
Cigna	$62 - $209	28%
United	$66 - $147	30%
Bright Health	$96 - $98	43%
Aetna	$104 - $172	46%
Colorado Program For Children With Special Needs	$109 - $111	49%
Western Plains Community Health	$208 - $212	93%
Multiplan	$224 - $342	100%
Northcare	$224 - $229	100%
Physician Health Partners	$224 - $229	100%
Blue Cross Blue Shield	$237 - $242	106%
Medical Development International	$256 - $261	114%
Prime Health	$288 - $294	129%
Pinnacol Workers Comp	$328	147%
Life Source Services	$350	156%

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 $326.
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 HCA Healthone Mountain Ridge 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.