CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Central Montana Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $81
Cash Discount Price: $122
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Central Montana Medical Center is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.36x the Medicare baseline. Located in 408 Wendell Ave, Lewistown, MT.

Cash / Self-Pay

$122

Average discount available for prompt cash payment at this facility.

Insurance Median

$81

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: $122 (55%)

Insurance Median: $81 (36%)

Cash: $122 (55% of Medicare)

Ins. Median: $81 (36% 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
Blue Cross Blue Shield	$8 - $137	4%
Humana	$8 - $82	4%
Triwest - All Plans	$8 - $81	4%
Veterans Affairs - All Plans	$8 - $81	4%
Montana Health Co-Op - All Plans	$27 - $147	12%
Allegiance Comm - All Other Plans	$28 - $146	13%
Allegiance Rbphp	$28 - $275	13%
Health Infonet - All Plans	$28 - $146	13%
Ebms - All Plans	$29 - $144	13%
Coventry/First Health - All Plans	$42 - $141	19%
UnitedHealthcare	$42 - $141	19%
Interwest Ppo	$44 - $149	20%
Pacific Source Hp - All Plans	$44 - $149	20%
Interwest Trad - All Other Plans	$45 - $152	20%

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 $122.
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 Central Montana Medical Center 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.