CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Transylvania Regional Hospital, Inc

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $40
  • Cash Discount Price: $89
  • vs. Medicare Baseline: 0.18x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Transylvania Regional Hospital, Inc is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.18x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.
Cash / Self-Pay
$89

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $89 (40%)
Insurance Median: $40 (18%)
Cash: $89 (40% of Medicare)
Ins. Median: $40 (18% 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 $11 - $110 5%
Amerihealth $12 - $52 5%
Apex Health $12 - $53 5%
Partners Health Management $12 - $53 5%
United $12 - $119 5%
Vaya Health $12 - $53 5%
Wellcare $12 - $52 5%
Aetna $16 - $192 7%
Cigna $22 - $135 10%
Amerihealth Caritas $25 - $109 11%
Caresource $27 - $117 12%
Oscar $27 - $121 12%
Medcost $28 - $226 13%
Magellan $36 - $159 16%
Magellan Behavioral Health $36 - $159 16%
Multiplan $48 - $212 21%
Avalon Administrative Services $51 - $226 23%
Prime Health $53 - $239 24%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 90 Hospital Drive Po Box 1116, Brevard, NC 28712
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals