CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Ochsner Medical Center-Kenner

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $119
Cash Discount Price: $42
vs. Medicare Baseline: 0.53x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Ochsner Medical Center-Kenner is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.53x the Medicare baseline. Located in 180 West Esplanade Avenue, Kenner, LA.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $42 (19%)

Insurance Median: $119 (53%)

Cash: $42 (19% of Medicare)

Ins. Median: $119 (53% 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
Humana	$25 - $187	11%
UnitedHealthcare	$25 - $412	11%
Aetna	$26 - $133	12%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$26	12%
Healthy Blue (Healthy Louisiana)	$26	12%
Louisiana Healthcare Connections (Healthy Louisiana)	$26	12%
Blue Cross Blue Shield	$62 - $187	28%
Zelis	$82	37%
Healthcomp & Personify Health (Formerly Gilsbar)	$89	40%
Claritev D/B/A Multiplan/Phcs/American Life Care	$96	43%
First Health Network	$112	50%
Louisiana Workers' Compensation Corporation (Lwcc)	$112	50%
Mississippi Physicians Care Network	$112	50%
Galaxy Health Network Ppo	$119	53%
Galaxy Health Network Wc	$119	53%
Employers Health Network (Ehn)	$127	57%
Prime Health Services Ppo	$127	57%
Usa Managed Care Network	$127	57%
Medicaid / KanCare	$158 - $166	71%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$184	82%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$187	84%
Medicare (plans)	$187	84%
Ochsner Health Plan	$187	84%
Tricare	$187	84%
Wellcare Of Louisiana	$192	86%
Cigna	$225	101%

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 $42.
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-Kenner 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.