CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Ascension St John Jane Phillips

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $207
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Ascension St John Jane Phillips is $207. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.93x the Medicare baseline. Located in 3500 East Frank Phillips Boulevard, Bartlesville, OK.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$207

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: $30 (13%)
Insurance Median: $207 (93%)
Cash: $30 (13% of Medicare)
Ins. Median: $207 (93% 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
First Health $15 7%
Aetna $19 - $28 8%
Blue Cross Blue Shield $38 - $218 17%
Champva $207 93%
Community Care - St John Network Senior - Govt $207 93%
Communitycare Senior $207 93%
Life Pace $207 93%
Longevity Health Plan Of Oklahoma $207 93%
Medicare (plans) $207 93%
UnitedHealthcare $207 - $213 93%
Va Community Care Network $207 93%
Veterans Administration $207 93%
Humana $209 93%
Communitycare (Standard) $228 102%
Community Care (Select) 7/1/13 $249 111%
Ccl&H $269 120%
Smarthealth $290 130%
Community Care Smarthealth $311 - $497 139%
Communitycare (Select) $311 - $477 139%
Connect Health Benefit $414 185%
Evolutions $414 185%
Kempton Group Administrators $466 208%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3500 East Frank Phillips Boulevard, Bartlesville, OK 74006
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals