CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: University of Louisville Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $221
Cash Discount Price: $99
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at University of Louisville Hospital is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.99x the Medicare baseline. Located in 530 South Jackson Street, Louisville, KY.

Cash / Self-Pay

$99

Average discount available for prompt cash payment at this facility.

Insurance Median

$221

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$223.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $223.72 (100%)

Cash / Self-Pay: $99 (44%)

Insurance Median: $221 (99%)

Cash: $99 (44% of Medicare)

Ins. Median: $221 (99% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$69	31%
Blue Cross Blue Shield	$69 - $412	31%
Humana	$69 - $191	31%
UnitedHealthcare	$69 - $197	31%
Passport	$72 - $254	32%
Prime Group Health	$114 - $350	51%
Devoted	$124 - $200	55%
Senior Care Community Of Ky	$187	84%
Cigna	$191	85%
Essence Health	$191	85%
Va Ccn	$191	85%
Signature	$196 - $206	88%
Communicare	$200	89%
Wellcare	$221 - $261	99%
Velocity	$233 - $404	104%
Key Benefit Administrators	$248	111%
Cshn	$268 - $412	120%
Multiplan	$272 - $371	122%
Encore	$288	129%
Health Smart	$309	138%
Omca	$391	175%
Corvel	$412	184%
National Comp Care	$412	184%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $99.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm University of Louisville Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.