CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Leconte Medical Center

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 Leconte Medical Center 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 742 Middlecreek Road, Sevierville, 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 $19 - $209 8%
Aetna $81 - $209 36%
UnitedHealthcare $81 - $223 36%
Ehn $91 - $137 41%
Ambetter / Centene $122 - $183 55%
Correctional Medical Services $122 - $183 55%
Community Services Network $132 - $198 59%
Cigna $136 - $209 61%
Usa Managed Care Organization $142 - $214 63%
Novanet $152 - $229 68%
Direct Care America $162 - $244 72%
Medsave Usa $162 - $244 72%
National Provider Network $162 - $244 72%
Beech Street $173 - $259 77%
Ccn Managed Care $173 - $259 77%
Wellpoint $175 - $209 78%
Initial Group $179 - $268 80%
Galaxy Health Network $183 - $274 82%
Farm Bureau $199 89%
Tricare $199 89%
Humana $205 92%
Devoted Health $209 93%
Wellcare $209 93%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 742 Middlecreek Road, Sevierville, TN 37862
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals