CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Bailey Medical Center, LLC

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $256
Cash Discount Price: $135
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Bailey Medical Center, LLC is $256. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.14x the Medicare baseline. Located in 10502 North 110Th East Avenue, Owasso, OK.

Cash / Self-Pay

$135

Average discount available for prompt cash payment at this facility.

Insurance Median

$256

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: $135 (60%)

Insurance Median: $256 (114%)

Cash: $135 (60% of Medicare)

Ins. Median: $256 (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.

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
Healthcare Highways [2210]	$112 - $123	50%
Hooray Health [8000]	$112	50%
Oncology Patient Assistance Programs [2295]	$112	50%
Oscar Insurance Company [7005]	$112	50%
Osma Health Network [2345]	$112	50%
Healthscope Benefits [2290]	$119	53%
UnitedHealthcare	$119	53%
Resource One Administrators [2815]	$123	55%
Web Tpa [2115]	$123 - $197	55%
Aetna	$197	88%
Coresource [1315]	$197	88%
Coventry Healthcare [1320]	$197	88%
Meritain Health [1655]	$197	88%
The Kempton Group Administrators [2905]	$202	90%
First Health [1375]	$227 - $368	101%
Medica [2910]	$227	101%
Multiplan [1680]	$227 - $368	101%
Healthcare Solutions [1485]	$256	114%
Community Care [1290]	$355	159%
Employee Benefit Management Services [2445]	$355	159%
Fmh Benefit Services [1390]	$355	159%
Group Resources [1455]	$355	159%
Phcs [1780]	$355 - $368	159%
Gilsbar [1425]	$368	164%
Healthcost Solutions [2415]	$368	164%
Healthfirst [2395]	$368	164%
Healthnet [1495]	$368	164%
Hometown Health [2155]	$368	164%
Mayo Clinic Health Solutions [2280]	$368	164%
Mutual Of Omaha [1685]	$368	164%
New Era Life Insurance Company [1705]	$368	164%
Pan American Life Insurance Co [1770]	$368	164%
Planned Administrators Inc [2360]	$368	164%
Trustmark [2030]	$368	164%
Universal Fidelity [2085]	$368	164%
Healthsmart [1505]	$382	171%
Pending Ssi [1616]	$449	201%

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 $135.
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 Bailey Medical Center, LLC 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.