CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Atrium Health Navicent the Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $125
  • Cash Discount Price: $131
  • vs. Medicare Baseline: 0.56x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Atrium Health Navicent the Medical Center is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.56x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.
Cash / Self-Pay
$131

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $131 (59%)
Insurance Median: $125 (56%)
Cash: $131 (59% of Medicare)
Ins. Median: $125 (56% 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
Aetna $7 - $198 3%
Blue Cross Blue Shield $7 - $198 3%
Care Source $7 - $202 3%
Clover $7 - $202 3%
Eon Health $7 - $202 3%
Georgia Health Advantage $7 - $198 3%
Humana $7 - $198 3%
Pruitt Health $7 - $198 3%
UnitedHealthcare $7 - $347 3%
Alliant $8 - $238 4%
Ambetter / Centene $9 - $134 4%
Cigna $25 - $266 11%
Securehealth $31 - $92 14%
Kaiser $34 - $170 15%
Multiplan $39 - $210 17%
Beechstreet $48 - $244 21%
Ibg $48 - $185 21%
Novanet $48 - $210 21%
Three Rivers Provider Network $51 - $223 23%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hemlock Street, Macon, GA 31201
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals