CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Blue Ridge Regional Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $30
  • Cash Discount Price: $99
  • vs. Medicare Baseline: 0.13x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Blue Ridge Regional Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.13x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$99

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $99 (44%)
Insurance Median: $30 (13%)
Cash: $99 (44% of Medicare)
Ins. Median: $30 (13% 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 $10 - $57 4%
United $10 - $65 4%
Amerihealth $11 - $24 5%
Partners Health Management $11 - $24 5%
Vaya Health $11 - $24 5%
Wellcare $11 - $24 5%
Aetna $12 - $99 5%
Apex Health $12 - $27 5%
Cigna $21 - $56 9%
Amerihealth Caritas $23 - $51 10%
Caresource $27 - $60 12%
Medcost $28 - $71 13%
Oscar $28 - $62 13%
Magellan $37 - $82 17%
Magellan Behavioral Health $37 - $82 17%
Multiplan $49 - $110 22%
Avalon Administrative Services $52 - $116 23%
Prime Health $54 - $123 24%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals