CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Carolina East Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $58
  • Cash Discount Price: $92
  • vs. Medicare Baseline: 0.26x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Carolina East Medical Center is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.26x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.
Cash / Self-Pay
$92

Average discount available for prompt cash payment at this facility.

Insurance Median
$58

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: $92 (41%)
Insurance Median: $58 (26%)
Cash: $92 (41% of Medicare)
Ins. Median: $58 (26% 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
Humana $8 - $209 4%
Inclusive Health (Nchirp)-All Plans $8 - $209 4%
Tricare $8 - $251 4%
Pamlico Co Jail-All Plans $15 - $67 7%
UnitedHealthcare $19 - $178 8%
Craven Co. Jail Systems - All Plans $20 - $85 9%
Medcost Ppo Employees And Retirees $36 - $165 16%
Medcost Ppo Ultra (Employees) $36 - $157 16%
Blue Cross Blue Shield $38 - $172 17%
Medcost Ppo City Employees $40 - $183 18%
Medcost Ppo County Employee $42 - $190 19%
Benefit Mgmt, Svcs-All Plans $47 - $213 21%
Aetna $49 - $222 22%
Medcost Benefit Svc-All Other Plans $49 - $222 22%
Acs Consult Svc Inc-All Plans $50 - $227 22%
Cigna $50 - $228 22%
Medcost Ppo Standard $50 - $227 22%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Neuse Blvd, New Bern, NC 28560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals