CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Bienville Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $424
Cash Discount Price: $471
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Bienville Medical Center is $424. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $471. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.90x the Medicare baseline. Located in 1175 Pine Street, Arcadia, LA.

Cash / Self-Pay

$471

Average discount available for prompt cash payment at this facility.

Insurance Median

$424

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: $471 (211%)

Insurance Median: $424 (190%)

Cash: $471 (211% of Medicare)

Ins. Median: $424 (190% 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	$46 - $784	21%
Medicaid / KanCare	$46 - $460	21%
Mmd Amerihealth Caritas	$46 - $460	21%
Mmd Healthy Blue	$46 - $460	21%
Mmd La Hlth Conn	$46 - $460	21%
Mmd Misc	$46 - $460	21%
UnitedHealthcare	$46 - $460	21%
Cashiering	$314 - $471	140%
Cigna	$392	175%
Ambetter / Centene	$424	190%
Humana	$424 - $507	190%
Mcr American Hlth Adv	$424	190%
Medicare (plans)	$424	190%
Misc Mgd Care	$424 - $784	190%
Mmc Blue Advantage	$424	190%
Mmc Misc	$424	190%
Peoples Health Mcr Adv	$424	190%
Va Health	$424	190%
Blue Cross Blue Shield	$472	211%
Wc City Of Arcadia	$706	316%
Wc House Of Raeford	$706	316%
Wc Misc	$706	316%
Wc Stonetrust	$706	316%
Aarp	$784	350%
Allegiance Health Managme	$784	350%
Amfirst	$784	350%
Apwu	$784	350%
Liberty Mutual	$784	350%
Misc Comm A-L	$784	350%
Misc Comm M-Z	$784	350%
Tricare	$784	350%

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 $471.
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 Bienville Medical Center 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.