CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Okeene Municipal Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $365
Cash Discount Price: $276
vs. Medicare Baseline: 1.63x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Okeene Municipal Hospital is $365. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $276. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.63x the Medicare baseline. Located in 207 East F Street, Okeene, OK.

Cash / Self-Pay

$276

Average discount available for prompt cash payment at this facility.

Insurance Median

$365

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: $276 (123%)

Insurance Median: $365 (163%)

Cash: $276 (123% of Medicare)

Ins. Median: $365 (163% 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
Pref Community Choice Ppo-All Plans	$7 - $96	3%
Blue Cross Blue Shield	$28 - $724	13%
Coventry Mcr Adv	$28 - $365	13%
Global Health Mcr Adv	$28 - $365	13%
Humana	$28 - $641	13%
Medicare (plans)	$28 - $365	13%
UnitedHealthcare	$28 - $456	13%
Cigna	$30 - $392	13%
Ihs-All Plans	$32 - $415	14%
Aetna	$34 - $641	15%
Healthchoice Ip Only-All Plans	$34 - $449	15%
Ok Complete Health Comm-All Other Plans	$34 - $446	15%
Global Health-All Other Plans	$36 - $475	16%
Healthcare Highways-All Plans	$37 - $481	17%
Phcs Savility/Multiplan - All Plans	$37 - $481	17%
Medica Commercial-All Other Plans	$38 - $493	17%
Community Care Hmo-All Plans	$44 - $577	20%
Ok Complete Health Mcaid	$49 - $641	22%

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 $276.
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 Okeene Municipal Hospital 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.