CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: University Health System, Inc

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $71
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 0.32x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at University Health System, Inc is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.32x the Medicare baseline. Located in 1924 Alcoa Highway, Knoxville, TN.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$71

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: $30 (13%)
Insurance Median: $71 (32%)
Cash: $30 (13% of Medicare)
Ins. Median: $71 (32% 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.

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 - $193 3%
American Health $7 - $197 3%
Blue Cross Blue Shield $7 - $195 3%
Choicecare $7 - $13 3%
Cigna $7 - $186 3%
Humana $7 - $186 3%
Nhc $7 - $197 3%
UnitedHealthcare $7 - $186 3%
Initial Group $16 7%
Coventry $17 - $83 8%
Multiplan $17 - $71 8%
Wellpoint $17 - $197 8%
Beechstreet $18 - $88 8%
First Health $18 8%
Tenncare $18 8%
Bluecare $20 9%
Novanet $21 9%
Fentress County Sheriffs Dept $47 21%
Nx Health $71 32%
Phcs $71 32%
Naphcare $77 34%
Prime Health $88 - $118 39%
Seven Corners $88 39%
Usa $94 42%
Evolutions $106 47%
Galaxy $106 47%
Healthsmart $106 47%
Devoted Health $193 86%
Wellcare-Windsor Medadv $195 87%
Medicare (plans) $197 - $199 88%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1924 Alcoa Highway, Knoxville, TN 37920
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals