CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: North Oaks Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $186
Cash Discount Price: $409
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at North Oaks Medical Center is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $409. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.83x the Medicare baseline. Located in 15790 Paul Vega Md Drive, Hammond, LA.

Cash / Self-Pay

$409

Average discount available for prompt cash payment at this facility.

Insurance Median

$186

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: $409 (183%)

Insurance Median: $186 (83%)

Cash: $409 (183% of Medicare)

Ins. Median: $186 (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
Mco Lhc	$92	41%
Aetna	$94 - $1,106	42%
Humana	$94 - $976	42%
Mco Hb	$94	42%
Mco Lacare Am	$94	42%
Medicaid / KanCare	$94	42%
UnitedHealthcare	$94 - $624	42%
Tricare	$155 - $186	69%
Allwell	$186	83%
Blue Advantage	$186	83%
Champva	$186	83%
Healthy Blue Dual Advantage	$186	83%
Peoples Health	$186	83%
Vantage 65	$186	83%
Veterans Administration	$186	83%
Wellcare	$186	83%
Blue Cross Blue Shield	$404 - $409	181%
Coventry	$846	378%
Verity Healthnet	$846	378%
Ppoplus Llc	$911	407%
Multiplan	$976	436%
Cigna	$1,028	460%

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 $409.
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 North Oaks Medical Center 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.