CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Terrebonne General Medical Center - Parish

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $198
Cash Discount Price: $444
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Terrebonne General Medical Center - Parish is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $444. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.89x the Medicare baseline. Located in 8166 Main Street, Houma, LA.

Cash / Self-Pay

$444

Average discount available for prompt cash payment at this facility.

Insurance Median

$198

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: $444 (198%)

Insurance Median: $198 (89%)

Cash: $444 (198% of Medicare)

Ins. Median: $198 (89% 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
Champ Va	$6	3%
Ppoplus	$38	17%
Medicaid / KanCare	$107	48%
UnitedHealthcare	$107 - $198	48%
Amerihealth	$110	49%
Aetna	$111 - $504	50%
Humana	$113 - $596	51%
Blue Cross Blue Shield	$195 - $458	87%
Dept Of Veterans Affairs	$195	87%
Medicare (plans)	$195	87%
Tricare	$198	89%
Amg	$208	93%
Verity Health	$342	153%
Multiplan Inc	$390	174%
Cigna	$403	180%
Coventry Health Of Louisiana	$480	215%
Vantage Health Plan	$496	222%
Gilsbar 360	$533 - $535	238%
Workers Comp	$600	268%

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 $444.
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 Terrebonne General Medical Center - Parish 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.