Breathing treatment (nebulizer)
Facility: University Of Ks Hlth System Great Bend Campus
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $226
- Cash Discount Price: $95
- vs. Medicare Baseline: 1.01x 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 |
|---|---|---|
| UnitedHealthcare | $83 - $204 | 37% |
| Geha [503200036] | $86 | 38% |
| Medica [503200074] | $86 | 38% |
| Workers Comp [503999901] | $86 - $403 | 38% |
| Hchsync Centrus Health Direct [503999916] | $130 - $150 | 58% |
| Alt Wppa [5032000964] | $199 | 89% |
| Meritain Health [503200039] | $199 - $284 | 89% |
| Wppa [503200056] | $199 | 89% |
| Ku Athletics [503200094] | $204 | 91% |
| Medicare (plans) | $209 | 93% |
| Allwell [503200078] | $211 | 94% |
| Blue Cross Blue Shield | $211 | 94% |
| Humana | $216 | 97% |
| Triwest [503201703] | $216 | 97% |
| Tricare | $216 | 97% |
| Alt Carelon Behavioral Health [503200905] | $237 | 106% |
| Centurion [5032000966] | $266 | 119% |
| Aetna | $284 | 127% |
| Php [503200005] | $284 | 127% |
| National Assn Letter Carriers [503200019] | $284 | 127% |
| Alt Meritain Health [503999911] | $284 | 127% |
| Aha-Healthcare Preferred [503200050] | $284 | 127% |
| Cigna | $284 - $379 | 127% |
| Allied National [503999937] | $284 | 127% |
| First Health [5032000110] | $284 | 127% |
| Ambetter / Centene | $296 | 132% |
| Correct Care Solutions [50311253] | $332 | 148% |
| Usa Managed Care [503999030] | $427 | 191% |
| Occunet [503999930] | $429 | 192% |
| Fort Hays State Student Athletes [5032000960] | $429 | 192% |
| 6 Degrees Health [503999050] | $511 | 228% |
| Advanced Medical Pricing Solutions [503301513] | $647 | 289% |
Consumer Guidance & Cost Commentary
For CPT code 94640, a breathing treatment using a nebulizer, the gross charge at the University of KS Health System Great Bend Campus is $474.00. This facility is located in Great Bend, KS, and its pricing is benchmarked against the national standard where Medicare reimbursement for this service is $223.72. The facility's negotiated rates vary significantly by payer, ranging from a low of $83 with UnitedHealthcare to a high of $647 with Advanced Medical Pricing Solutions. While the facility is a government-owned acute care hospital with a 4-star rating, patients should be aware that commercial negotiated rates often exceed the cash price of $95.00, which can be the most cost-effective option for those with high-deductible plans or those who do not have insurance coverage.
To minimize costs, patients should proactively contact the hospital's billing department to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full upfront. It is important to verify your specific plan's negotiated rate before scheduling, as in-network allowances can differ widely even within the same hospital system. Additionally, if you are self-paying, request a detailed, itemized bill to ensure no errors or unbundled charges are included, as over 80% of hospital bills contain discrepancies. Always compare the facility's allowed amounts to the Medicare benchmark to understand the true cost relative to the national average, rather than relying on the hospital's full chargemaster list which is inflated for billing purposes.