CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Novant Health Huntersville Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $154
Cash Discount Price: $136
vs. Medicare Baseline: 0.69x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Novant Health Huntersville Medical Center is $154. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.69x the Medicare baseline. Located in 10030 Gilead Road, Huntersville, NC.

Cash / Self-Pay

$136

Average discount available for prompt cash payment at this facility.

Insurance Median

$154

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: $136 (61%)

Insurance Median: $154 (69%)

Cash: $136 (61% of Medicare)

Ins. Median: $154 (69% 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
Blue Cross Blue Shield	$12 - $213	5%
Carolina Complete	$33 - $34	15%
Nc Department Of Public Safety	$33 - $426	15%
Amerihealth	$34 - $35	15%
UnitedHealthcare	$34 - $213	15%
Wellcare	$34 - $35	15%
Caresource North Carolina	$88 - $91	39%
Atlantic Corporation Dba Atlantic Packaging	$123 - $126	55%
Cigna	$138 - $219	62%
Aetna	$140 - $220	63%
Amps	$147 - $151	66%
Plotkin Health	$160 - $165	72%
Medcost	$190 - $206	85%
Humana	$192 - $213	86%
Primary Physician Care	$198 - $204	89%
Multiplan	$200 - $206	89%
Phcs	$200 - $206	89%
Pace Of The Southern Piedmont	$213	95%
Liberty Health	$223	100%
Employers Choice Network	$259 - $267	116%
Three Rivers Provider Network	$259 - $267	116%

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 $136.
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 Novant Health Huntersville Medical Center 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.