CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Hillcrest Hospital Cushing

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $221
Cash Discount Price: $107
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Hillcrest Hospital Cushing is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.99x the Medicare baseline. Located in 1027 East Cherry Street, Cushing, OK.

Cash / Self-Pay

$107

Average discount available for prompt cash payment at this facility.

Insurance Median

$221

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: $107 (48%)

Insurance Median: $221 (99%)

Cash: $107 (48% of Medicare)

Ins. Median: $221 (99% 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
Black Lung [6055]	$89	40%
Healthcare Highways [2210]	$89 - $106	40%
Hooray Health [8000]	$89	40%
Lucent Health [6000]	$89	40%
Oncology Patient Assistance Programs [2295]	$89	40%
Oscar Insurance Company [7005]	$89	40%
Healthscope Benefits [2290]	$97	43%
UnitedHealthcare	$97 - $176	43%
Web Tpa [2115]	$106 - $156	47%
Aetna	$156	70%
Coresource [1315]	$156	70%
Coventry Healthcare [1320]	$156	70%
Meritain Health [1655]	$156	70%
Cigna	$174	78%
Healthpartners [1500]	$174	78%
National Association Of Letter Carriers [1695]	$174	78%
Pba [1775]	$174	78%
Global Health [1430]	$221	99%
First Health [1375]	$247 - $313	110%
Multiplan [1680]	$247 - $313	110%
Healthcare Solutions [1485]	$253	113%
Community Care [1290]	$295	132%
Fmh Benefit Services [1390]	$295	132%
Group Resources [1455]	$295	132%
Phcs [1780]	$295 - $313	132%
Healthsmart [1505]	$303	135%
Administrative Concepts [1005]	$313	140%
Allied Benefit Systems Inc [1030]	$313	140%
Allied National Global Care [1035]	$313	140%
Gilsbar [1425]	$313	140%
Healthnet [1495]	$313	140%
Mutual Of Omaha [1685]	$313	140%
New Era Life Insurance Company [1705]	$313	140%
Pan American Life Insurance Co [1770]	$313	140%
Trustmark [2030]	$313	140%
Universal Fidelity [2085]	$313	140%
Pending Ssi [1616]	$356	159%

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 $107.
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 Hillcrest Hospital Cushing 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.