CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: The Children's Mercy Hospital

Billing Code: 94640 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$105

about 0.5× the $224 Medicare rate · typically $17–$301

modeled estimate · not a bill or quote

Medicare pays $224 Fair price $105 Cash price $87 Hospital's list price $181

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$73 - $530	33%
Blue Cross Blue Shieldmajor	$74 - $134	33%
Aetnamajor	$109 - $134	49%
Cignamajor	$87 - $126	39%
Humanamajor	$120	54%
Health Net	$134	60%
HealthLink	$159	71%
Medica	$106	47%
+ 11 smaller / regional plans	$77 - $530

Government programs also on file: Medicaid.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 87), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 94640.

Insurance Before you use insurance

Call your insurance company to confirm The Children's Mercy Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 94640.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at The Children's Mercy Hospital

Compare: Breathing treatment (nebulizer) at other MO hospitals

Insurance negotiated median for the same procedure, sorted lowest first.