CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Artesia General Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $197
Cash Discount Price: $163
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Artesia General Hospital is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.88x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$163

Average discount available for prompt cash payment at this facility.

Insurance Median

$197

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: $163 (73%)

Insurance Median: $197 (88%)

Cash: $163 (73% of Medicare)

Ins. Median: $197 (88% 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
Zelis	$56 - $236	25%
First Health	$79 - $426	35%
Blue Cross Blue Shield	$122 - $284	55%
Geha	$142 - $379	63%
Omni Networks	$142 - $331	63%
Three Rivers Provider Network	$153 - $355	68%
Cigna	$173 - $426	77%
UnitedHealthcare	$173 - $402	77%
Galaxy Health	$183 - $426	82%
One Health Plan	$183 - $426	82%
Multiplan	$185 - $431	83%
United Payors & United Providers	$189 - $440	84%
Providence Risk & Insurance Services	$193 - $450	86%
Triwest	$193	86%
Humana	$197 - $217	88%
Molina Healthcare Of New Mexico	$197 - $331	88%
Presbyterian Health Plan	$197 - $230	88%
Vistacare Hospice	$197	88%
New Mexico Health Connections	$335	150%

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 $163.
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 Artesia General 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.