CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Oakdale Community Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $276
Cash Discount Price: $91
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Oakdale Community Hospital is $276. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.23x the Medicare baseline. Located in 130 N Hospital Dr, Oakdale, LA.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$276

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: $91 (41%)

Insurance Median: $276 (123%)

Cash: $91 (41% of Medicare)

Ins. Median: $276 (123% 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	$20 - $557	9%
Meritain	$20 - $557	9%
Amfirst	$55 - $198	25%
Self Pay	$55 - $198	25%
Medicaid / KanCare	$61 - $219	27%
UnitedHealthcare	$61 - $219	27%
Humana	$67 - $624	30%
Web-Tpa	$138 - $496	62%
Cigna	$150 - $559	67%
Ima	$165 - $991	74%
Ppo Plus	$165 - $595	74%
Wc Gulf South Risk Srvcs	$248 - $892	111%
Wc Martco	$248 - $892	111%
Wc Misc	$248 - $892	111%
Wc Risk Mgmnt-Baton Rouge	$248 - $892	111%
Wc Sedwick Workmans Comp	$248 - $892	111%
Wc Us Department Of Labor	$248 - $892	111%
American Public Life	$275 - $991	123%
American Retirement Life	$275 - $991	123%
Apwu	$275 - $991	123%
Auto Liability	$275 - $991	123%
Bankers Life	$275 - $991	123%
Correct Care	$275 - $991	123%
Fox Everitt	$275 - $991	123%
Mailhandlers Benefit Plan	$275 - $991	123%
Medishare	$275 - $991	123%
Medplus	$275 - $991	123%
Misc Commerical	$275 - $991	123%
Phcs	$275 - $991	123%
Physicians Mutual	$275 - $991	123%
State Farm-La	$275 - $991	123%
Triwest	$275 - $991	123%
Us Family Health Plan	$275 - $991	123%
Usaa	$275 - $991	123%
Blue Cross Blue Shield	$302	135%

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 $91.
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 Oakdale Community 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.