CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Fairview Park Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $237
Cash Discount Price: $649
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Fairview Park Hospital is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $649. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.06x the Medicare baseline. Located in 200 Industrial Boulevard, Dublin, GA.

Cash / Self-Pay

$649

Average discount available for prompt cash payment at this facility.

Insurance Median

$237

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: $649 (290%)

Insurance Median: $237 (106%)

Cash: $649 (290% of Medicare)

Ins. Median: $237 (106% 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
Amerigroup	$51 - $123	23%
Ambetter / Centene	$56 - $134	25%
Friday Health	$57 - $137	25%
Nhc Advantage	$73 - $174	33%
Pruitt Health	$73 - $174	33%
Peach State	$77 - $183	34%
Wellcare	$77 - $183	34%
Memorial Health Plan	$84 - $412	38%
United	$95 - $412	42%
Aetna	$99 - $504	44%
Cigna	$104 - $332	46%
Centurion	$106 - $253	47%
Americas 1St Choice	$107 - $256	48%
Leavitt Risk Partners	$115 - $274	51%
Health One Alliance	$176 - $421	79%
Dodge County Hospital	$192 - $457	86%
American Steel Products	$326 - $778	146%
City Of Eastman	$326 - $778	146%
Dodge Co Board Of Commissioners	$326 - $778	146%
Graham Brothers Construction	$326 - $778	146%
Multiplan	$345 - $823	154%
Novanet	$345 - $823	154%
Prime Health	$511	228%
Employer'S Health Network	$522	233%
Rockport United Network	$522	233%
Identity Mco	$533	238%
Synergy Health Network	$533	238%

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 $649.
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 Fairview Park Hospital 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.