CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Ochsner Medical Center - Baton Rouge

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $164
Cash Discount Price: $70
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Ochsner Medical Center - Baton Rouge is $164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.73x the Medicare baseline. Located in 17000 Medical Center Dr, Baton Rouge, LA.

Cash / Self-Pay

$70

Average discount available for prompt cash payment at this facility.

Insurance Median

$164

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: $70 (31%)

Insurance Median: $164 (73%)

Cash: $70 (31% of Medicare)

Ins. Median: $164 (73% 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
Zelis	$25	11%
Humana	$43 - $187	19%
UnitedHealthcare	$43 - $341	19%
Aetna	$44 - $175	20%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$44	20%
Healthy Blue (Healthy Louisiana)	$44	20%
Louisiana Healthcare Connections (Healthy Louisiana)	$44	20%
Blue Cross Blue Shield	$66 - $187	30%
Claritev D/B/A Multiplan/Phcs/American Life Care	$131	59%
Healthcomp & Personify Health (Formerly Gilsbar)	$131	59%
Medicaid / KanCare	$158	71%
Louisiana Workers' Compensation Corporation (Lwcc)	$164	73%
Mississippi Physicians Care Network	$164	73%
First Health Network	$175	78%
Prime Health Services Ppo	$186	83%
Usa Managed Care Network	$186	83%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$187	84%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$187	84%
Medicare (plans)	$187	84%
Ochsner Health Plan	$187	84%
Tricare	$187	84%
Cigna	$266	119%

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 $70.
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 Ochsner Medical Center - Baton Rouge 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.