CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Novant Health Thomasville Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $176
  • Cash Discount Price: $163
  • vs. Medicare Baseline: 0.79x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Novant Health Thomasville Medical Center is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.79x the Medicare baseline. Located in 207 Old Lexington Rd Box 789, Thomasville, NC.
Cash / Self-Pay
$163

Average discount available for prompt cash payment at this facility.

Insurance Median
$176

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: $163 (73%)
Insurance Median: $176 (79%)
Cash: $163 (73% of Medicare)
Ins. Median: $176 (79% 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 $12 - $212 5%
Amerihealth $49 - $51 22%
Carolina Complete $49 - $50 22%
Nc Department Of Public Safety $49 - $425 22%
UnitedHealthcare $49 - $212 22%
Wellcare $49 - $51 22%
Cigna $106 - $219 47%
Caresource North Carolina $107 - $110 48%
Atlantic Corporation Dba Atlantic Packaging $151 - $155 67%
Plotkin Health $160 - $165 72%
Amps $174 - $179 78%
Aetna $191 - $220 85%
Humana $208 - $214 93%
Pace Of The Southern Piedmont $212 95%
Liberty Health $223 100%
Medcost $227 - $258 101%
Primary Physician Care $235 - $242 105%
Multiplan $240 - $248 107%
Phcs $240 - $248 107%
Employers Choice Network $259 - $267 116%
Three Rivers Provider Network $259 - $267 116%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 207 Old Lexington Rd Box 789, Thomasville, NC 27360
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals