CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Magee General Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $203
Cash Discount Price: $200
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Magee General Hospital is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $200. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.91x the Medicare baseline. Located in 300 3Rd Ave Se, Magee, MS.

Cash / Self-Pay

$200

Average discount available for prompt cash payment at this facility.

Insurance Median

$203

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: $200 (89%)

Insurance Median: $203 (91%)

Cash: $200 (89% of Medicare)

Ins. Median: $203 (91% 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
Magnolia Health Plan Mcd Rep	$152	68%
Medicaid / KanCare	$152	68%
Mississippi Childrens Health Insurance Program	$152	68%
Molina Healthcare Of Ms Mcd Adv	$152	68%
UnitedHealthcare	$152 - $203	68%
Aetna	$203	91%
Ambetter / Centene	$203	91%
Harmony Health Plan Of Illinois	$203	91%
Humana	$203	91%
Medicare (plans)	$203	91%
Shared Health Mississippi Mcr Adv	$203	91%
Vantage Health Plan Inc Mcr Adv Primewell Health	$203	91%
Wellcare Health Plan Inc Mcr Adv	$203	91%
Blue Cross Blue Shield	$255	114%
Mississippi State Employees And Teachers	$255	114%

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 $200.
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 Magee General 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.