Breathing treatment (nebulizer)
Facility: Greenwood County Hospital
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $39
- Cash Discount Price: $31
- vs. Medicare Baseline: 0.17x 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 |
|---|---|---|
| Triwest - All Plans | $14 - $125 | 6% |
| Tricare | $16 - $147 | 7% |
| UnitedHealthcare | $16 - $294 | 7% |
| Choicecare Mcr Adv - All Plans | $16 - $147 | 7% |
| Integrated Health Plan - All Plans | $29 - $262 | 13% |
| First Health - All Other Plans | $33 - $298 | 15% |
| First Health Ccn Network | $33 - $298 | 15% |
| Beech Street - All Plans | $33 - $298 | 15% |
| Preferred Hs (Coventry) - All Plans | $35 - $315 | 16% |
| Principal Health Care Inc - All Plans | $37 - $332 | 17% |
| Blue Cross Blue Shield | $39 - $41 | 17% |
| Amerigroup Mcaid-All Plans | $39 - $350 | 17% |
| Medicaid / KanCare | $39 - $350 | 17% |
| Providrs Care/Wppa - All Plans | $58 - $525 | 26% |
Consumer Guidance & Cost Commentary
For the CPT code 94640, "Breathing treatment (nebulizer)," Greenwood County Hospital's cash median rate of $31.00 is lower than the facility's negotiated median of $39.00 and the gross charge of $39.00. When comparing these rates to the Medicare benchmark of $223.72, the cash price represents a significant discount, aligning closer to the fair pricing range of 120% to 150% of the Medicare rate rather than the typical commercial markup of 200% to 300%. While the facility is a Critical Access Hospital in Eureka, KS, with government local ownership, patients with high-deductible plans may find the cash price more advantageous than the insurance negotiated rates, which range from $14 to $525 across 14 different payers. It is important to note that while the cash rate is lower than the gross charge, the actual savings depend on whether the patient's insurance deductible has been met and the specific allowed amount for their plan.
Patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling services, as hospitals often offer fee reductions of 20% to 50% for upfront payments that bypass costly insurance claims processing. Since the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should verify their network status to avoid unexpected bills. If a balance bill does occur, consumers should request a formal itemized billing audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies.