Breathing treatment (nebulizer)
Facility: Ascension Via Christi Hospitals Wichita, Inc.
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $190
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.85x 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 |
|---|---|---|
| Va | $188 | 84% |
| Via Christi Research | $188 | 84% |
| Medicare (plans) | $188 - $192 | 84% |
| Humana | $188 | 84% |
| Vc Hope | $188 | 84% |
| Saint Lukes Health Systems | $188 | 84% |
| Blue Cross Blue Shield | $192 | 86% |
| UnitedHealthcare | $192 - $527 | 86% |
| Corizon | $235 | 105% |
| Smarthealth | $263 | 118% |
| Medicaid / KanCare | $320 | 143% |
Consumer Guidance & Cost Commentary
For this CPT code representing a breathing treatment via nebulizer, Ascension Via Christi Hospitals Wichita, Inc. has a median negotiated rate of $190.00 across 11 payers, with the lowest rates starting at $188 and the highest reaching $527 for UnitedHealthcare. This facility is located in Wichita, Kansas, and its pricing structure is significantly lower than the state average, which sits at $223.72 based on Medicare benchmarks. While the facility's negotiated rates are generally competitive, patients should note that cash-pay options are not listed in the current data; however, it is always advisable to inquire directly with the hospital about self-pay or prompt-pay discounts, which can offer substantial fee reductions for upfront payment.
The facility's Medicare benchmark of $223.72 serves as a reliable baseline for evaluating pricing fairness, as commercial negotiated rates often exceed this figure due to administrative costs and contract dynamics. Although the median negotiated rate of $190.00 appears lower than the Medicare amount, patients must be aware that insurance reimbursement is not the same as the total cost to the patient. If a patient has a high-deductible plan that has not yet been met, they may face out-of-pocket costs that exceed the facility's cash price, making it financially prudent to verify their specific deductible status before scheduling. Additionally, because this is an in-network facility, the No Surprises Act protects patients from balance billing for emergency services or out-of-network ancillary providers, ensuring that the final bill aligns with the negotiated rates provided.