Breathing treatment (nebulizer)
Facility: Goodland Regional Medical Center
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $99
- Cash Discount Price: $99
- vs. Medicare Baseline: 0.44x 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 | $42 | 19% |
| Wppa | $94 - $99 | 42% |
| UnitedHealthcare | $99 | 44% |
Consumer Guidance & Cost Commentary
For the CPT code 94640, representing a breathing treatment via nebulizer, Goodland Regional Medical Center lists a gross charge of $110.00. The facility's cash median price is $99.00, which aligns with the median negotiated rate of $99.00. This cash price is significantly lower than the Medicare benchmark of $223.72, indicating a markup of only 40% above the federal baseline. While the facility is a Critical Access Hospital in Kansas with a government-local ownership structure, the specific data provided does not include comparative averages for the Goodland county or Kansas state, so a direct comparison to regional pricing standards cannot be made based on the available figures.
Patients should be aware that while insurance plans like Blue Cross Blue Shield, Wppa, and UnitedHealthcare have negotiated rates ranging from $42 to $99, these amounts may not be the lowest possible option. In cases where a patient has a high deductible or limited insurance coverage, paying the cash price of $99.00 upfront could result in lower out-of-pocket costs compared to the insurance negotiated rate, especially if the patient's plan has not yet met its deductible threshold. To maximize savings, it is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative processing fees associated with insurance claims.