CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Ochsner American Legion Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $185
Cash Discount Price: $73
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Ochsner American Legion Hospital is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.83x the Medicare baseline. Located in 1634 Elton Road, Jennings, LA.

Cash / Self-Pay

$73

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: $73 (33%)

Insurance Median: $185 (83%)

Cash: $73 (33% 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	$7 - $386	3%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$7 - $303	3%
Blue Cross Blue Shield	$7 - $955	3%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$7 - $294	3%
Humana	$7 - $352	3%
Medicare (plans)	$7 - $294	3%
Ochsner Health Plan	$7 - $294	3%
Tricare	$7 - $185	3%
UnitedHealthcare	$7 - $527	3%
Wellcare Of Louisiana	$7 - $294	3%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$8 - $352	4%
Healthy Blue (Healthy Louisiana)	$8 - $352	4%
Louisiana Healthcare Connections (Healthy Louisiana)	$8 - $352	4%
Provider Network Of America	$9 - $314	4%
Verity Commercial And First Choice Network	$12 - $196	5%
Cigna	$14 - $100	6%
Zelis	$17 - $293	8%
Healthcomp & Personify Health (Formerly Gilsbar)	$20 - $332	9%
Louisiana Workers' Compensation Corporation (Lwcc)	$24 - $908	11%

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 $73.
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 American Legion 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.