CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Duncan Regional Hospital, Inc

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $254
  • Cash Discount Price: $415
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Duncan Regional Hospital, Inc is $254. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $415. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.14x the Medicare baseline. Located in 1407 Whisenant Drive, Duncan, OK.
Cash / Self-Pay
$415

Average discount available for prompt cash payment at this facility.

Insurance Median
$254

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: $415 (185%)
Insurance Median: $254 (114%)
Cash: $415 (185% of Medicare)
Ins. Median: $254 (114% 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
Medica $113 - $134 51%
Healthcare Highways $118 - $208 53%
UnitedHealthcare $183 - $218 82%
Humana $207 93%
Oklahoma Health Network (Ohn) $215 - $256 96%
Aetna $229 - $272 102%
Coventry $229 - $272 102%
Cigna $242 - $288 108%
First Health $242 - $288 108%
Osma Health $242 - $288 108%
Preferred Community Choice $247 - $294 110%
Healthsmart $253 - $301 113%
Friday Health Plan $529 236%
Blue Cross Blue Shield $1,064 - $1,671 476%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1407 Whisenant Drive, Duncan, OK 73533
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals