CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Ochsner Medical Center Acute

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $184
Cash Discount Price: $51
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Ochsner Medical Center Acute is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.82x the Medicare baseline. Located in 1516 Jefferson Hwy, New Orleans, LA.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$184

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: $51 (23%)

Insurance Median: $184 (82%)

Cash: $51 (23% of Medicare)

Ins. Median: $184 (82% 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
Healthy Blue (Healthy Louisiana)	$35	16%
Humana	$35 - $187	16%
Louisiana Healthcare Connections (Healthy Louisiana)	$35	16%
UnitedHealthcare	$35 - $447	16%
Aetna	$36 - $125	16%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$36	16%
Blue Cross Blue Shield	$73 - $187	33%
Tricare	$73 - $187	33%
Medicaid / KanCare	$158 - $166	71%
First Health Network	$172	77%
Louisiana Workers' Compensation Corporation (Lwcc)	$172	77%
Mississippi Physicians Care Network	$172	77%
Healthcomp & Personify Health (Formerly Gilsbar)	$182	81%
Claritev D/B/A Multiplan/Phcs/American Life Care	$184	82%
Zelis	$184	82%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$187	84%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$187	84%
Medicare (plans)	$187	84%
Ochsner Health Plan	$187	84%
Employers Health Network (Ehn)	$196	88%
Prime Health Services Ppo	$196	88%
Usa Managed Care Network	$196	88%
Pace New Orleans	$205	92%
Behavioral Health Systems	$207	93%
Evolutions Healthcare	$207	93%
Galaxy Health Network Ppo	$207	93%
Galaxy Health Network Wc	$207	93%
Christus Health Exchange Plan	$371	166%
Cigna	$441	197%

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 $51.
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 Medical Center Acute 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.