CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Wakemed, Cary Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $189
Cash Discount Price: $135
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Wakemed, Cary Hospital is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.84x the Medicare baseline. Located in 1900 Kildare Farm Road, Cary, NC.

Cash / Self-Pay

$135

Average discount available for prompt cash payment at this facility.

Insurance Median

$189

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: $135 (60%)

Insurance Median: $189 (84%)

Cash: $135 (60% of Medicare)

Ins. Median: $189 (84% 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
Ambetter / Centene	$12 - $179	5%
Blue Cross Blue Shield	$28 - $235	13%
Amerihealth	$35 - $70	16%
Carolina Complete	$35 - $70	16%
Healthy Blue	$35 - $70	16%
Wellcare	$35 - $70	16%
Cigna	$69 - $241	31%
Aetna	$106 - $321	47%
First Health	$109 - $415	49%
Medcost	$170 - $354	76%
Phcs	$189 - $378	84%
Cary - Alignment	$206	92%
Multiplan	$212 - $425	95%
Cary - Liberty	$236	105%
Cary - Pruitt	$236	105%
Cary - Wellcare	$236	105%

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 $135.
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 Wakemed, Cary Hospital 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.