CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Northside Hospital Cherokee

Billing Code: 94640 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$233

about 1.0× the $224 Medicare rate · typically $39–$314

modeled estimate · not a bill or quote

What this hospital charges insurers

$219

About the fair price

about $14 under the fair price · 1.0× Medicare

Medicare pays $224 Fair price $233 This hospital $219 Cash price $373 Hospital's list price $498

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

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

Cheapest $27 Priciest $219

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

A fair price for a Breathing treatment (nebulizer) is about $233 (about 1.0× the $224 Medicare rate). Northside Hospital Cherokee charges insurers about $219, or about $373 in cash — about the fair price. Located in Canton, GA.

What each insurance company pays

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

6 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	$137 - $520	61%
Blue Cross Blue Shieldmajor	$73 - $512	33%
Aetnamajor	$130 - $500	58%
Cignamajor	$39 - $463	17%
Humanamajor	$221 - $228	99%
Kaiser Permanentemajor	$169 - $639	76%
Ambetter (Centene)	$29 - $345	13%
Amerigroup	$29 - $109	13%
CareSource	$30 - $273	13%
Clover Health	$230	103%
Health Net	$161 - $456	72%
Oscar Health	$122 - $345	55%
WellCare	$225	101%
+ 24 smaller / regional plans	$7 - $735

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 9 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 373), 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 Northside Hospital Cherokee 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 Northside Hospital Cherokee

Compare: Breathing treatment (nebulizer) at other GA hospitals

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