CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Doctors Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $348
  • Cash Discount Price: $1,257
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Doctors Hospital is $348. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,257. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.56x the Medicare baseline. Located in 3651 Wheeler Road, Augusta, GA.
Cash / Self-Pay
$1,257

Average discount available for prompt cash payment at this facility.

Insurance Median
$348

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: $1,257 (562%)
Insurance Median: $348 (156%)
Cash: $1,257 (562% of Medicare)
Ins. Median: $348 (156% 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
Blue Choice $11 5%
Cigna $82 - $349 37%
Amerigroup $92 - $216 41%
Ambetter / Centene $95 - $222 42%
United $101 - $685 45%
Friday Health $110 - $259 49%
Absolute Total Care $117 - $274 52%
Nhc Advantage $123 - $289 55%
Pruitt Health $123 - $289 55%
Peach State $130 - $304 58%
Wellcare $130 - $304 58%
Aetna $139 - $839 62%
Centurion $180 - $421 80%
Americas 1St Choice $182 - $426 81%
Health One Alliance $298 - $700 133%
Medcost $325 - $973 145%
Kaiser Permanente $355 - $832 159%
Multiplan $389 - $1,370 174%
Performax $441 - $1,035 197%
First Health $487 - $1,141 218%
Prime Health $511 228%
Employer'S Health Network $519 - $1,218 232%
Rockport United Network $522 233%
Identity Mco $533 238%
Novanet $584 - $1,370 261%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3651 Wheeler Road, Augusta, GA 30909
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals