CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: S E Lackey Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $264
Cash Discount Price: $36
vs. Medicare Baseline: 1.18x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at S E Lackey Memorial Hospital is $264. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.18x the Medicare baseline. Located in 330 N Broad Street, Forest, MS.

Cash / Self-Pay

$36

Average discount available for prompt cash payment at this facility.

Insurance Median

$264

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: $36 (16%)

Insurance Median: $264 (118%)

Cash: $36 (16% of Medicare)

Ins. Median: $264 (118% 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 Mcr Adv	$6 - $264	3%
UnitedHealthcare	$6 - $472	3%
Va Ccn - All Plans	$7 - $264	3%
Wellcare Mcr Adv - All Plans	$7 - $264	3%
Corvel - All Plans	$19 - $566	8%
Cigna	$50 - $525	22%
Blue Cross Blue Shield	$100 - $472	45%
Magnolia Mcaid	$147 - $155	66%
Magnolia Comm/Exch - All Other Plans	$264	118%
Aetna	$500	223%
First/Health Choice - All Plans	$503	225%
Health Partners - All Plans	$522	233%
Multiplan - All Plans	$566	253%

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 $36.
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 S E Lackey Memorial 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.