CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Lake Charles Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $174
Cash Discount Price: $233
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Lake Charles Memorial Hospital is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $233. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.78x the Medicare baseline. Located in 1701 Oak Park Blvd, Lake Charles, LA.

Cash / Self-Pay

$233

Average discount available for prompt cash payment at this facility.

Insurance Median

$174

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: $233 (104%)

Insurance Median: $174 (78%)

Cash: $233 (104% of Medicare)

Ins. Median: $174 (78% 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	$44 - $616	20%
Medicaid / KanCare	$44 - $86	20%
Meritain	$126 - $224	56%
Verity	$134 - $239	60%
Ppo_Plus_	$168 - $299	75%
Blue Cross Blue Shield	$174	78%
Champus_Va	$174	78%
Cigna	$174 - $374	78%
Medicare (plans)	$174	78%
Tricare	$174	78%
Veterans_Administration	$174	78%
Veterans_Choice-Triwest	$174	78%
Humana	$178 - $609	80%
Phcs	$196 - $349	88%
United_Healthcare_Behavorial_Health	$196 - $349	88%
Lwcc	$214 - $381	96%
First_Health	$224 - $398	100%
Workers_Compensation	$252 - $448	113%
Coushatta_Tribe_Dept_Of_Health	$313	140%
United_Healthcare	$313 - $422	140%
Blue_Cross_Blue_Shield_La	$380	170%
Vantage_Commercial	$400	179%

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 $233.
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 Lake Charles Memorial 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.