CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Barnes Jewish Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $257
Cash Discount Price: $238
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Barnes Jewish Hospital is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $238. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.15x the Medicare baseline. Located in One Barnes-Jewish Hospital Plaza, Saint Louis, MO.

Cash / Self-Pay

$238

Average discount available for prompt cash payment at this facility.

Insurance Median

$257

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: $238 (106%)

Insurance Median: $257 (115%)

Cash: $238 (106% of Medicare)

Ins. Median: $257 (115% 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
Healthlink [225]	$192 - $299	86%
Blue Cross Blue Shield	$218 - $345	97%
Cox Health Systems Insurance Company [220]	$218 - $257	97%
Health Alliance [224]	$218	97%
Healthscope Benefits [258]	$218 - $257	97%
UnitedHealthcare	$218 - $294	97%
Aetna	$219 - $297	98%
Essence Healthcare [221]	$219	98%
Humana	$219 - $259	98%
Cigna	$220 - $317	98%
Consociate [478]	$226	101%
Sarah Bush Lincoln [636]	$226	101%
Allied Benefits [498]	$230 - $294	103%
Cox Health [757]	$230	103%
Devoted Health Plan [847]	$230	103%
Hope Trust [806]	$230	103%
Medica [662]	$230	103%
Coresource [497]	$243	109%
Fmh Benefit Service Inc [222]	$243	109%
Mail Handlers [495]	$243	109%
Med-Pay [480]	$257 - $297	115%
Unicare [568]	$257 - $299	115%
Apwu Health Plan [216]	$266	119%
Nalc Health Benefit Plan [242]	$266	119%
Priority Health [648]	$266	119%
First Health Commercial [734]	$294	131%
Beechstreet [551]	$297	133%
Detego Health [868]	$297	133%
Health Systems Inc [620]	$297	133%
Healthcare Sol Mercy [609]	$297	133%
Multiplan Commercial [737]	$297	133%
Multiplan [240]	$297	133%
Phcs [244]	$297 - $317	133%
Preferred Health Professionals [561]	$299	134%
Medica [661]	$317	142%
Hfn [563]	$337	151%

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 $238.
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 Barnes Jewish 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.