CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: North Carolina Baptist Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $18
  • Cash Discount Price: $26
  • vs. Medicare Baseline: 0.08x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at North Carolina Baptist Hospital is $18. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.08x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$26

Average discount available for prompt cash payment at this facility.

Insurance Median
$18

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: $26 (12%)
Insurance Median: $18 (8%)
Cash: $26 (12% of Medicare)
Ins. Median: $18 (8% 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.

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 $10 - $197 4%
Medcost $10 - $35 4%
Amerihealth $11 - $14 5%
Carolina Complete $11 - $12 5%
Health Blue $11 - $12 5%
Partners $11 - $12 5%
UnitedHealthcare $11 - $197 5%
Vaya $11 - $12 5%
Wellcare $11 - $197 5%
Aetna $12 - $197 5%
Alliance $12 5%
Trillium $12 5%
Ambetter / Centene $14 6%
Cigna $15 - $197 7%
Oscar $15 - $19 7%
Humana $27 - $199 12%
Directnet $30 - $31 13%
Cone Health $35 - $37 16%
Healthgram $35 - $37 16%
First Carolina Care $40 - $42 18%
Private Healthcare Systems $41 - $43 18%
Multiplan $45 - $48 20%
Apex $197 88%
Devoted $197 88%
Healthteam $197 88%
Medicare (plans) $199 89%
Liberty $226 101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals