CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Wheatland Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $74
Cash Discount Price: $80
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Wheatland Memorial Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.33x the Medicare baseline. Located in 530 3Rd St Nw, Harlowton, MT.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $80 (36%)

Insurance Median: $74 (33%)

Cash: $80 (36% of Medicare)

Ins. Median: $74 (33% 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
Healthnet Federal-All Plans	$51 - $514	23%
Humana	$51 - $514	23%
Medica Prime Solutions-All Plans	$51 - $514	23%
Pacific Source Mcr Adv	$51 - $514	23%
Triwest-All Plans	$51 - $514	23%
Amish Old Orders-All Plans	$57 - $62	25%
Allegiance Provider-All Plans	$65 - $71	29%
6 Degrees Health-All Plans	$72 - $79	32%
Americas Choice-All Plans	$72 - $79	32%
Community Health Ntwk-All Plans	$72 - $79	32%
Fedmed Network-All Plans	$72 - $79	32%
First Choice Big Sky-All Plans	$72 - $79	32%
Interwest Ppo-All Plans	$72 - $79	32%
Mountain Health Co-Op-All Plans	$72 - $79	32%
Pacific Source-All Other Plans	$72 - $79	32%
Pacific Steel & Recycling-All Plans	$72 - $79	32%
Rocky Mountain Health Network-All Plans	$72 - $79	32%
Three Rivers-All Plans	$72 - $79	32%
First Health-All Plans	$73 - $80	33%
Ccn-All Plans	$74 - $81	33%
UnitedHealthcare	$74 - $82	33%
City Of Billings-All Plans	$114 - $125	51%

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 $80.
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 Wheatland 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.