CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Oklahoma Heart Hospital South, LLC

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $95
Cash Discount Price: $48
vs. Medicare Baseline: 0.42x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Oklahoma Heart Hospital South, LLC is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.42x the Medicare baseline. Located in 5200 East I-240 Service Road, Oklahoma City, OK.

Cash / Self-Pay

$48

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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: $48 (21%)

Insurance Median: $95 (42%)

Cash: $48 (21% of Medicare)

Ins. Median: $95 (42% 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
Aetna	$6 - $3,118	3%
Humana	$6 - $3,118	3%
Healthcare Highways	$13 - $82	6%
Healthscope	$24 - $63	11%
Oscar Insurance Company	$24 - $63	11%
Webtpa Chickasaw Nation Hch	$25 - $65	11%
Webtpa Hobby Lobby Hch	$28 - $73	13%
Coventry	$31 - $14,802	14%
Global Health	$33 - $87	15%
Sana Benefits	$34 - $89	15%
Ufcw	$34 - $89	15%
First Health Network	$36 - $95	16%
Manhattan Life	$36 - $95	16%
Cigna	$37 - $5,000	17%
Community Care	$37 - $6,236	17%
Phcs	$37 - $96	17%
Preferred Community Choice	$40 - $104	18%
Multiplan	$47 - $124	21%
Blue Cross Blue Shield	$211 - $3,118	94%
Medicare (plans)	$211 - $3,212	94%
UnitedHealthcare	$211 - $3,312	94%
Va Ccn	$211 - $3,118	94%
Geha	$224 - $3,312	100%
Ambetter / Centene	$295 - $4,365	132%
The Kempton Group	$527 - $7,795	236%

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 $48.
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 Oklahoma Heart Hospital South, 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.