Breathing treatment (nebulizer)
Facility: Cheyenne County Hospital
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $108
- Cash Discount Price: $114
- vs. Medicare Baseline: 0.48x 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 | $41 | 18% |
| First Health - All Plans | $80 | 36% |
| UnitedHealthcare | $82 - $550 | 37% |
| Tricare | $82 | 37% |
| Aetna | $82 - $108 | 37% |
| Healthy Blue Mcr Adv | $82 | 37% |
| Choice Care - All Plans | $83 | 37% |
| Firstguard - All Plans | $91 | 41% |
| Wppa - All Plans | $103 | 46% |
| Cpm - All Plans | $108 | 48% |
| Preferred Hc - All Plans | $108 | 48% |
| Midlands Choice - All Plans | $111 | 50% |
| Ppo Next - All Plans | $112 | 50% |
| Health Partners - All Plans | $112 | 50% |
| Unicare - All Plans | $112 | 50% |
| Integrated Hp - All Plans | $112 | 50% |
| Healthwave Mcaid - All Plans | $114 | 51% |
| Healthy Blue Mcaid - All Other Plans | $114 | 51% |
| Childrens Mercy - All Plans | $114 | 51% |
| Providers Care-All Plans | $171 | 76% |
Consumer Guidance & Cost Commentary
For the CPT code 94640, representing a breathing treatment via nebulizer, Cheyenne County Hospital lists a cash price of $114.00, which matches the facility's negotiated median of $108.00 and the cash median. This rate is notably lower than the national average for this service, where the cash median is $114.00 and the negotiated median is $102.00. While the facility's cash price aligns with the national cash average, patients with high-deductible plans may find paying out-of-pocket at $114.00 more cost-effective than relying on insurance, as some commercial payers negotiate rates that can exceed the cash price. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final amount owed.
The facility's pricing is evaluated against the Medicare benchmark of $223.72, which serves as a scientifically validated baseline for the true cost of care. The hospital's cash rate of $114.00 represents approximately 51% of the Medicare amount, indicating a markup that is significantly lower than the typical commercial range of 200% to 300% of Medicare. When comparing to the broader market, the facility's cash price is consistent with the national average, though individual payer negotiated rates vary widely, ranging from $41 to $171 across 20 different insurance plans. Consumers should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, it is still prudent to request