CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Womans Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $326
Cash Discount Price: $15,910
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Womans Hospital is $326. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,910. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.46x the Medicare baseline. Located in 100 Woman's Way, Baton Rouge, LA.

Cash / Self-Pay

$15,910

Average discount available for prompt cash payment at this facility.

Insurance Median

$326

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: $15,910 (7112%)

Insurance Median: $326 (146%)

Cash: $15,910 (7112% of Medicare)

Ins. Median: $326 (146% 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
Webtpa [100127]	$244 - $320	109%
Fmolhs Employees [100257]	$285	127%
UnitedHealthcare	$301 - $326	135%
Blue Cross Blue Shield	$320	143%
La Women'S Healthcare [100265]	$320	143%
Verity [100266]	$320	143%
Aetna	$326 - $383	146%
Cigna	$326 - $338	146%
Coventry [100010]	$326	146%
Ppo Plus [100259]	$326	146%
Beech Street [100260]	$346	155%
Multiplan [100258]	$358	160%
Private Health [100261]	$358	160%
Humana	$383	171%
Meritain [100063]	$383	171%

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 $15,910.
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 Womans 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.