Breathing treatment (nebulizer)
Facility: Neosho Memorial Regional Medical Center
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $60
- Cash Discount Price: $94
- vs. Medicare Baseline: 0.27x 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 |
|---|---|---|
| Tricare | $18 - $385 | 8% |
| Blue Cross Blue Shield | $19 - $399 | 8% |
| Va_Ccn | $19 - $399 | 8% |
| Aetna | $19 - $399 | 8% |
| Humana | $19 - $399 | 8% |
| Medadv_Allwell | $19 - $399 | 8% |
| Medadv_Uhc | $19 - $399 | 8% |
| Medicare (plans) | $19 - $399 | 8% |
| Ambetter / Centene | $30 - $629 | 13% |
| Wppa_Providrscare | $49 - $1,036 | 22% |
| United | $50 - $1,038 | 22% |
| Hpk | $57 - $1,186 | 25% |
| Coventry | $57 - $1,186 | 25% |
| Cigna | $57 - $1,186 | 25% |
| Medicaid / KanCare | $60 - $69 | 27% |
Consumer Guidance & Cost Commentary
For the CPT code 94640, representing a breathing treatment via nebulizer, Neosho Memorial Regional Medical Center in Chanute, KS, lists a gross charge of $125.00. While the facility's cash median rate is $94.00, commercial insurance negotiated rates vary significantly by plan, ranging from a low of $18.00 with Tricare to a high of $1,186.00 with Hpk and Coventry. The facility's cash price is notably lower than the state average for this service, which sits at $125.00, and is also below the national average of $135.00. Patients with high-deductible plans may find the cash price of $94.00 more affordable than their specific insurance allowed amount, which could exceed the cash rate depending on their carrier.
To minimize out-of-pocket costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is important to avoid balance billing, as the No Surprises Act prohibits providers from charging patients the difference between the chargemaster and the insurance allowed amount for emergency care or non-emergency services at in-network facilities. If a patient receives an unexpected bill, they should request a formal itemized audit to verify that all charges correspond to services actually rendered and that no unbundled codes were applied.