CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Ochsner LSU Health Monroe

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $185
Cash Discount Price: $108
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Ochsner LSU Health Monroe is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.83x the Medicare baseline. Located in 4864 Jackson Street, Monroe, LA.

Cash / Self-Pay

$108

Average discount available for prompt cash payment at this facility.

Insurance Median

$185

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: $108 (48%)

Insurance Median: $185 (83%)

Cash: $108 (48% of Medicare)

Ins. Median: $185 (83% 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	$46 - $331	21%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$46 - $75	21%
Healthy Blue (Formerly Amerigroup Louisiana Inc.)	$46 - $75	21%
Humana	$46 - $185	21%
Louisiana Healthcare Connections (Healthy Louisiana)	$46 - $75	21%
UnitedHealthcare	$46 - $223	21%
Blue Cross Blue Shield	$78 - $185	35%
Cigna	$114	51%
Verity Health Network – Lsu First Choice	$121 - $197	54%
(Healthy Louisiana) And Healthy Blue Dual Advantage (Hmo-D-Snp)	$185	83%
Medicare (plans)	$185	83%
Multiplan/Phcs/American Lifecare	$202 - $328	90%
First Health Network	$203 - $331	91%
Vantage Health Plan - Commercial	$203	91%
Usa Managed Care Network	$216 - $352	97%
Zelis	$325	145%
Healthcomp Ppo (Formerly Gilsbar 360	$462	207%

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 $108.
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 Ochsner LSU Health Monroe 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.