CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Byrd Regional Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $189
Cash Discount Price: $95
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Byrd Regional Hospital is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.84x the Medicare baseline. Located in 1020 Fertitta Blvd, Leesville, LA.

Cash / Self-Pay

$95

Average discount available for prompt cash payment at this facility.

Insurance Median

$189

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: $95 (42%)

Insurance Median: $189 (84%)

Cash: $95 (42% of Medicare)

Ins. Median: $189 (84% 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	$13 - $456	6%
Coventry Healthcare Of La	$13 - $272	6%
Amerihealth Caritas	$33 - $64	15%
Correct Care Int Hth	$33 - $64	15%
Healthy Blue	$33 - $64	15%
La Healthcare Conn Mdcaid	$33 - $64	15%
Medicaid / KanCare	$33 - $64	15%
UnitedHealthcare	$33 - $456	15%
Humana	$37 - $71	17%
Self Pay	$77 - $137	34%
Cigna	$152 - $290	68%
Verity Health	$180 - $319	80%
Us Dept Of Labor	$231 - $410	103%
Workers Comp	$231 - $410	103%
Aflac	$256 - $456	114%
American Health Advantage	$256 - $456	114%
Amfirst	$256 - $456	114%
Hospice Of Leesville	$256 - $456	114%
Industrial	$256 - $456	114%
Misc Comm	$256 - $456	114%
Mischmoppo	$256 - $456	114%
Mutual Of Omaha	$256 - $456	114%
Mva	$256 - $456	114%
Phcs Private Health	$256 - $456	114%
Physicans Mutual	$256 - $456	114%
State Farm Insurance	$256 - $456	114%
Sterling	$256 - $456	114%
Stonetrust	$256 - $456	114%
Tri Parish Rehab	$256 - $456	114%
United Teacher Asso	$256 - $456	114%
Web Tpa	$256 - $456	114%
Blue Cross Blue Shield	$319	143%

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 $95.
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 Byrd Regional 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.