Breathing treatment (nebulizer)
Facility: Morris County Hospital
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $195
- Cash Discount Price: $138
- vs. Medicare Baseline: 0.87x 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 | $90 - $262 | 40% |
| Coventry Mcr | $90 - $102 | 40% |
| Blue Cross Blue Shield | $90 - $254 | 40% |
| Choice Care Mcr Adv-All Plans | $90 - $102 | 40% |
| Va Ccn-All Plans | $90 - $102 | 40% |
| Cigna | $166 - $190 | 74% |
| Aetna | $206 - $235 | 92% |
| Coventry Comm-All Other Plans | $207 - $236 | 93% |
| Multiplan-All Plans | $207 - $236 | 93% |
| Providrs Care (Wppa)(Nexus)-All Plans | $345 - $393 | 154% |
Consumer Guidance & Cost Commentary
For this CPT code representing a breathing treatment (nebulizer) at Morris County Hospital in Council Grove, KS, the facility's cash median price of $138.00 is lower than the state average for this service. While the facility's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $90 to $262, the cash price remains the most transparent baseline for comparison. It is important to note that for patients with high-deductible plans, paying the cash price of $138.00 upfront can sometimes be more cost-effective than relying on insurance, as the insurer's negotiated rate often exceeds the cash amount due to administrative overhead and contract dynamics.
Patients should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final cost by bypassing the administrative fees associated with insurance claims. Additionally, if you receive a bill that includes charges for services not rendered or unbundled components, you should request a formal itemized audit to ensure accuracy, as over 80% of hospital bills contain errors. Finally, while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is crucial to review your specific plan details and avoid signing away your rights to dispute out-of-network costs without understanding the implications.