CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Avoyelles Hospital
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $225
- Cash Discount Price: $83
- vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Avoyelles Hospital is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.01x the Medicare baseline. Located in 4231 Highway 1192, Marksville, LA.
Cash / Self-Pay
$83
Average discount available for prompt cash payment at this facility.
Insurance Median
$225
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: $83 (37%)
Insurance Median: $225 (101%)
Cash: $83 (37% of Medicare)
Ins. Median: $225 (101% 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
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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 | $21 - $185 | 9% |
| Amer Contl Ins | $21 - $185 | 9% |
| Coventry | $21 - $185 | 9% |
| First Choice Health | $21 - $185 | 9% |
| Meritan Health | $21 - $330 | 9% |
| Cigna | $47 - $186 | 21% |
| Correct Cr Int Hlt | $47 - $69 | 21% |
| Mcd Amerihealth Caritas | $47 - $69 | 21% |
| Mcd Healthy Blue | $47 - $69 | 21% |
| Mcd La Hc Conn | $47 - $69 | 21% |
| Medicaid / KanCare | $47 - $69 | 21% |
| UnitedHealthcare | $47 - $69 | 21% |
| Mcd Ms | $51 - $76 | 23% |
| Student Assurances | $68 - $330 | 30% |
| Humana | $81 - $187 | 36% |
| Ppo Plus Llc | $135 - $198 | 60% |
| Zelis Healthcare Bpa | $135 - $198 | 60% |
| Gilsbar | $142 - $208 | 63% |
| Amerind | $202 - $297 | 90% |
| Applied Underwriters | $202 - $297 | 90% |
| Sedgwick | $202 - $297 | 90% |
| Us Dept Of Labor | $202 - $297 | 90% |
| Wc Clms Admin Svcs | $202 - $297 | 90% |
| Wc Clms Mgmnt Walmart | $202 - $297 | 90% |
| Wc Esis | $202 - $297 | 90% |
| Wc Fara | $202 - $297 | 90% |
| Wc Gallagher Bassett | $202 - $297 | 90% |
| Wc Guide One | $202 - $297 | 90% |
| Wc Hartford Med | $202 - $297 | 90% |
| Wc Luba | $202 - $297 | 90% |
| Wc Lwcc | $202 - $297 | 90% |
| Wc Paragon Casino Resort | $202 - $297 | 90% |
| Wc Risk Mgmnt | $202 - $297 | 90% |
| Wc Stone Trust | $202 - $297 | 90% |
| Wc Summit Consulting Hold | $202 - $297 | 90% |
| Wc Travelers Ins | $202 - $297 | 90% |
| Wc Trs Workers Comp Claim | $202 - $297 | 90% |
| Wc Us Dol | $202 - $297 | 90% |
| Wc Zurich | $202 - $297 | 90% |
| Aarp | $225 - $330 | 101% |
| Admin Concepts | $225 - $330 | 101% |
| All Saints Hospice | $225 - $330 | 101% |
| All State | $225 - $330 | 101% |
| Allegiance Health Hospice | $225 - $330 | 101% |
| Allied Natl | $225 - $330 | 101% |
| Amfirst | $225 - $330 | 101% |
| Avoy Parish School Board | $225 - $330 | 101% |
| Avoyelles Parish Sheriff | $225 - $330 | 101% |
| Bollinger | $225 - $330 | 101% |
| Ccmsi | $225 - $330 | 101% |
| Central States | $225 - $330 | 101% |
| Christus Health Plan | $225 - $330 | 101% |
| Compassionate Care Hospic | $225 - $330 | 101% |
| Core Source | $225 - $330 | 101% |
| Coushatta Hlth Dept | $225 - $330 | 101% |
| Ebms | $225 - $330 | 101% |
| Federated Ins | $225 - $330 | 101% |
| Feedom Life | $225 - $330 | 101% |
| Fidelity Standard Life Co | $225 - $330 | 101% |
| Fox Everette | $225 - $330 | 101% |
| Guarantee Trust | $225 - $330 | 101% |
| Heart Of Hospice | $225 - $330 | 101% |
| Hos Christus Hospice | $225 - $330 | 101% |
| Hos Guardian Hospice Care | $225 - $330 | 101% |
| Hos Harbor Hospice Alex | $225 - $330 | 101% |
| Hos La Hospice Palliative | $225 - $330 | 101% |
| Hos Passages Hospice N. | $225 - $330 | 101% |
| Hos St Joseph Hospice | $225 - $330 | 101% |
| Hospice Miscellaneous | $225 - $330 | 101% |
| Ins Mgmnt Admin | $225 - $330 | 101% |
| Ins Tpa | $225 - $330 | 101% |
| Liberty Health Share | $225 - $330 | 101% |
| Lumico | $225 - $330 | 101% |
| Manhattan Life Ins | $225 - $330 | 101% |
| Medi Share | $225 - $330 | 101% |
| Misc Comm | $225 - $330 | 101% |
| Nalc | $225 - $330 | 101% |
| New Era Life | $225 - $330 | 101% |
| North American | $225 - $330 | 101% |
| Phcs | $225 - $330 | 101% |
| Physicians Mutual | $225 - $330 | 101% |
| Pipeline Ind Bene | $225 - $330 | 101% |
| Progressive Auto | $225 - $330 | 101% |
| Reliance Standard Life | $225 - $330 | 101% |
| Rural Carriers | $225 - $330 | 101% |
| Shelter Ins Co | $225 - $330 | 101% |
| Sierre Health And Life | $225 - $330 | 101% |
| State Farm | $225 - $330 | 101% |
| State Mutual | $225 - $330 | 101% |
| Sterling Investors | $225 - $330 | 101% |
| The Health Plan | $225 - $330 | 101% |
| Tribal Hlth Partners | $225 - $330 | 101% |
| Tricare | $225 - $330 | 101% |
| Trustmark Health Benefits | $225 - $330 | 101% |
| Tunica Biloxi | $225 - $330 | 101% |
| Uct | $225 - $330 | 101% |
| Unified Life | $225 - $330 | 101% |
| Usaa Life Ins | $225 - $330 | 101% |
| Web-Tpa | $225 - $330 | 101% |
| Woodmen Of The World | $225 - $330 | 101% |
| Blue Cross Blue Shield | $288 | 129% |
| Ofc Of Grp Bene | $288 | 129% |