CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Abbeville General Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $73
Cash Discount Price: $43
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Abbeville General Hospital is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.33x the Medicare baseline. Located in 118 N Hospital Dr, Abbeville, LA.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $43 (19%)

Insurance Median: $73 (33%)

Cash: $43 (19% of Medicare)

Ins. Median: $73 (33% 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
Triwest Healthcare Alliance	$6 - $17	3%
Blue Cross Blue Shield	$8 - $195	4%
Cigna	$12 - $76	5%
Self Pay	$13 - $77	6%
Humana	$16 - $496	7%
Aetna	$18 - $195	8%
American Lifecare (Phcs)	$19 - $123	8%
Gilsbar Ppo	$19 - $119	8%
Ppo Plus	$19 - $115	8%
United Behavioral Health Inc	$19 - $115	8%
Verity Healthnet National	$19 - $115	8%
Guardian Resources	$20 - $123	9%
UnitedHealthcare	$20 - $198	9%
Coventry Company	$21 - $131	9%
Galaxy Health Network	$21 - $131	9%
Usa Managed Care	$21 - $131	9%
Health Payors Organization	$23 - $138	10%
Ppo Plus Professional	$23	10%
Miscellaneous Insurance	$25 - $154	11%
Wellcare Of Louisiana	$25 - $154	11%
Vantage Health Plan	$45 - $419	20%
Magellan Behavioral Health	$46 - $48	21%
Office Of Group Benefits	$56	25%
Healthy Blue	$195	87%
People'S Health	$195	87%
Medicare (plans)	$198	89%
Sierra Health And Life Insurance	$198	89%
Sterling Life Insurance Company	$198	89%
Med-Comp Usa Inc	$317	142%

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 $43.
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 Abbeville General 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.