CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Mercy Hospital Marietta

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $82
Cash Discount Price: $137
vs. Medicare Baseline: 0.37x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Mercy Hospital Marietta is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $137. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.37x the Medicare baseline. Located in 300 Wanda Street, Marietta, OK.

Cash / Self-Pay

$137

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

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: $137 (61%)

Insurance Median: $82 (37%)

Cash: $137 (61% of Medicare)

Ins. Median: $82 (37% 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	$7 - $95	3%
Humana	$7 - $44	3%
Medicaid / KanCare	$7	3%
Blue Cross Blue Shield	$44 - $68	20%
Cross Timbers Hospice [20098]	$44	20%
Elara Caring Aspire Hospice Contracted [320433]	$44	20%
Elara Caring Aspire Hospice [20433]	$44	20%
Halo Hcr Inc Hospice Contracted [320432]	$44	20%
Halo Hcr Inc Hospice [20432]	$44	20%
Independent Health [20197]	$44	20%
Indian Health Service Contracted [320198]	$44	20%
Kindful Hospice Contracted [320434]	$44	20%
Kindful Hospice [20434]	$44	20%
Medical Associates Health [20444]	$44	20%
Medicare (plans)	$44 - $47	20%
Mercy Hospice Okc [20252]	$44	20%
Tricare	$47	21%
UnitedHealthcare	$47 - $96	21%
Cigna	$48 - $103	21%
Webtpa Contracted [320417]	$58	26%
Aither Health Contracted [320449]	$82 - $116	37%
Mercy Benefit Admin Contracted [320251]	$82 - $123	37%
Quik Trip Contracted [320447]	$82	37%
Show-Me Health Administrators Contracted [320483]	$82	37%
Osma Health Contracted [320292]	$96	43%
United Medical Resources Contracted [320454]	$96 - $123	43%
First Health Contracted [320128]	$97	43%
Benefit Management Contracted [320052]	$103 - $123	46%
Healthcare Highways Plus Contracted [320175]	$103	46%
Auxiant Contracted [320462]	$116 - $123	52%
Ebms Contracted [320493]	$116	52%
Healthlink Contracted [320179]	$116 - $123	52%
Preferred Community Choice Contracted [320311]	$116	52%
Federal Medical Center Contracted [320127]	$123	55%
Healthscope Contracted [320182]	$123	55%
Point C Contracted [320238]	$123	55%
Preferred Health Plan Contracted [320522]	$123	55%
Tri State Healthcare Coalition Contracted [320379]	$123	55%

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 $137.
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 Mercy Hospital Marietta 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.