CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Hawkins County Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $199
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Hawkins County Memorial Hospital is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.89x the Medicare baseline. Located in 851 Locust Street, Rogersville, TN.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$199

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: $79 (35%)
Insurance Median: $199 (89%)
Cash: $79 (35% of Medicare)
Ins. Median: $199 (89% 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
Blue Cross Blue Shield $15 - $611 7%
UnitedHealthcare $15 - $199 7%
Optima Health $82 37%
Aetna $83 - $281 37%
Molina Healthcare $84 - $209 38%
Sentara Health $104 - $199 46%
Cigna $168 - $305 75%
Medcost $191 - $313 85%
Humana $199 89%
Managed Medicaire $199 89%
Medicare (plans) $199 89%
United Mine Workers Of America $199 89%
Amerigroup $207 93%
Devoted Health Plan $209 93%
Mountain Empire Pace $209 93%
Nhc Advantage $209 93%
Wellcare $211 - $657 94%
First Health Coventry $362 - $591 162%
Seven Corners, Inc. $402 - $657 180%
Ambetter / Centene $433 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 851 Locust Street, Rogersville, TN 37857
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals