CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Prisma Health Greer Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $196
Cash Discount Price: $291
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Prisma Health Greer Memorial Hospital is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $291. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.88x the Medicare baseline. Located in 1413 John B White Sr Blvd Suite D, Spartanburg, SC.

Cash / Self-Pay

$291

Average discount available for prompt cash payment at this facility.

Insurance Median

$196

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: $291 (130%)

Insurance Median: $196 (88%)

Cash: $291 (130% of Medicare)

Ins. Median: $196 (88% 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
Choicecare Network	$7 - $381	3%
Humana	$7 - $178	3%
Tricare	$7 - $187	3%
Blue Choice Healthplan Of Sc	$8	4%
Molina	$8 - $202	4%
Select Health	$8 - $198	4%
Medicaid / KanCare	$9 - $67	4%
Bluechoice Healthplan Of Sc	$10 - $152	4%
Sc Workers Compensation	$10 - $262	4%
Wellpath Select Inc	$10 - $257	4%
Blue Cross Blue Shield	$60 - $191	27%
Prisma Health Seniorcare Pace-Upstate	$108	48%
Medicare (plans)	$134 - $196	60%
Aetna	$157 - $394	70%
Veterans Administration	$187	84%
Cigna	$193 - $358	86%
Liberty Advantage	$193	86%
UnitedHealthcare	$194 - $947	87%
Absolute Total Care Prime	$196	88%
Windsor Health Plan	$196	88%
Value Options	$224	100%
Promise Health Plan	$269	120%
Preferred Care, Inc	$314	140%
Chp Direct Supermed Network	$323	144%
Celtic Insurance Company	$327	146%
Medcost	$332	148%
Atlantic Packaging	$336	150%
Aps Healthcare Bethesda Inc	$358	160%
Medcost Preferred	$367	164%
Multiplan	$399	178%
Companion Benefit Alternatives	$448	200%
Miscellaneous	$448	200%
Self Pay	$448	200%

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 $291.
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 Prisma Health Greer Memorial 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.