CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Methodist Hospitals of Memphis

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $211
Cash Discount Price: $997
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Methodist Hospitals of Memphis is $211. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $997. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.94x the Medicare baseline. Located in 1265 Union Ave Suite 700, Memphis, TN.

Cash / Self-Pay

$997

Average discount available for prompt cash payment at this facility.

Insurance Median

$211

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: $997 (446%)

Insurance Median: $211 (94%)

Cash: $997 (446% of Medicare)

Ins. Median: $211 (94% 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
Medicaid / KanCare	$6 - $3,807	3%
UnitedHealthcare	$13 - $7,142	6%
Blue Cross Blue Shield	$15 - $4,520	7%
Cigna	$119 - $9,437	53%
Molina Healthcare [350012]	$158 - $395	71%
American Health Advantage Mcr Adv [450117]	$186 - $4,520	83%
Carecentrix [450200]	$186 - $4,520	83%
Generic Hospice Vbid [10940000101]	$186 - $4,520	83%
Humana	$186 - $4,520	83%
Medicare (plans)	$186 - $4,520	83%
Va Hospital [600005]	$186 - $4,520	83%
Tricare	$191 - $4,449	85%
Devoted Health [450111]	$192 - $4,656	86%
Select Specialty Hospital [100298]	$242 - $371	108%
United Food & Commercial Workers [100309]	$389 - $9,437	174%
Langston Performance Health [100405]	$4,283	1914%

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 $997.
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 Methodist Hospitals of Memphis 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.