CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Colleton Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $334
Cash Discount Price: $716
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Colleton Medical Center is $334. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $716. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.49x the Medicare baseline. Located in 501 Robertson Boulevard, Walterboro, SC.

Cash / Self-Pay

$716

Average discount available for prompt cash payment at this facility.

Insurance Median

$334

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: $716 (320%)

Insurance Median: $334 (149%)

Cash: $716 (320% of Medicare)

Ins. Median: $334 (149% 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
Blue Choice	$11	5%
United	$11 - $395	5%
Blue Choice Health Plan	$69 - $72	31%
Blue Cross Blue Shield	$69 - $706	31%
Sc State Employees	$75 - $85	34%
Absolute Total Care	$108 - $134	48%
Molina	$134	60%
Nhc Advantage	$141	63%
Pruitt Health	$141	63%
Select Health	$319	143%
Employers Health Network	$334	149%
Value Option	$372	166%
Vocational Rehab	$401	179%
Medcost	$419 - $542	187%
Aetna	$430	192%
Cigna	$480	215%
Humana	$483 - $669	216%
Mhnet	$557	249%
Evernorth	$594	266%
Multiplan	$632	282%
North American Administrators	$632	282%
Prime Health	$632	282%
First Health	$669	299%
Novanet	$669	299%

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 $716.
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 Colleton Medical Center 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.