CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Novant Health Forsyth Medical Center

Billing Code: 94640 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$226

about 1.0× the $224 Medicare rate · typically $99–$386

modeled estimate · not a bill or quote

What this hospital charges insurers

$227

About the fair price

about $1 over the fair price · 1.0× Medicare

Medicare pays $224 Fair price $226 This hospital $227 Cash price $241 Hospital's list price $401

How we calculate the fair BaseRate →

How this hospital compares to other NC hospitals

Highest price of the 9 NC hospitals we have prices for — worth calling around.

Cheapest $20 Priciest $227

Black dot = this hospital, among the 9 NC hospitals with a price for this procedure. Full list below.

A fair price for a Breathing treatment (nebulizer) is about $226 (about 1.0× the $224 Medicare rate). Novant Health Forsyth Medical Center charges insurers about $227, or about $241 in cash — about the fair price. Located in Winston-Salem, NC.

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	$75 - $274	34%
Blue Cross Blue Shieldmajor	$12 - $280	5%
Aetnamajor	$218 - $326	97%
Cignamajor	$153 - $242	68%
Humanamajor	$212 - $317	95%
AmeriHealth	$75 - $77	34%
CareSource	$158 - $163	71%
WellCare	$75 - $77	34%
+ 10 smaller / regional plans	$73 - $425

Excludes 4 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 241), 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 Novant Health Forsyth Medical Center 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 Novant Health Forsyth Medical Center

Compare: Breathing treatment (nebulizer) at other NC hospitals

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