Breathing treatment (nebulizer)
Facility: St. Catherine Hospital - Garden City
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $157
- Cash Discount Price: $155
- vs. Medicare Baseline: 0.70x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 Cross Blue Shield | $7 - $459 | 3% |
| Kansas Health | $7 | 3% |
| Kaiser | $7 - $113 | 3% |
| Aetna | $7 - $226 | 3% |
| Medicare (plans) | $7 - $8 | 3% |
| UnitedHealthcare | $7 - $238 | 3% |
| Humana | $7 - $8 | 3% |
| Cigna | $7 - $507 | 3% |
| Innovage | $8 | 4% |
| Devoted Health | $8 | 4% |
| Direct To Employer | $75 - $164 | 34% |
| Denver Health | $91 - $97 | 41% |
| Centura Employee Plan | $94 - $205 | 42% |
| Peak Health | $99 - $160 | 44% |
| United Colorado Doctor'S Plan | $145 - $154 | 65% |
| Wpaa | $188 | 84% |
| Christian Health Aid | $215 | 96% |
| Multiplan | $242 - $348 | 108% |
| Health Partners Of Kansas | $261 | 117% |
Consumer Guidance & Cost Commentary
For the CPT code 94640, representing a breathing treatment via nebulizer, St. Catherine Hospital - Garden City lists a gross charge of $388.00, which is significantly higher than the facility's own cash median of $155.00 and the state of Kansas average. While the hospital's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $7 to $238, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that the facility's cash median of $155.00 is lower than the state average of $175.00, and the negotiated median of $157.00 is also below the state average, suggesting that the facility's pricing structure is competitive relative to the broader region.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, unexpected charges can still arise from out-of-network ancillary services or if a patient is billed for the difference between the provider's chargemaster and the insurance allowed amount. To avoid these surprises, consumers should request a full itemized bill before paying and verify that all services rendered are accurately coded, as over 80% of hospital bills contain errors. Additionally, since the facility offers a voluntary non-profit status and is located in Garden City, KS, patients are encouraged to ask specifically about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront, bypassing the administrative costs associated with