CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Physicians Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $201
  • Cash Discount Price: $238
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Physicians Regional Medical Center is $201. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $238. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.90x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.
Cash / Self-Pay
$238

Average discount available for prompt cash payment at this facility.

Insurance Median
$201

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: $238 (106%)
Insurance Median: $201 (90%)
Cash: $238 (106% of Medicare)
Ins. Median: $201 (90% 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
Veterans Eval Services $7 3%
Blue Cross Blue Shield $16 - $208 7%
Medicaid / KanCare $65 29%
UnitedHealthcare $65 - $1,074 29%
Amerigroup $136 - $205 61%
Amerigroup Community Care $136 61%
Tricare $189 84%
Humana $195 87%
Medicare (plans) $195 87%
Node Bluecare Plus Tn Mcr Adv $195 - $199 87%
Department Of Veterans Affairs $199 89%
Node Devoted Health Mcr Adv $199 89%
Node Farm Bureau Mcr Adv $199 89%
Node Hospice Non Par Agree $199 89%
Node Va $199 89%
Aetna $201 - $470 90%
Node Healthspring Mcr Adv $201 90%
Wellcare $207 93%
Node Nhc Mcr Adv $215 96%
Self Pay $234 - $243 105%
Node Us Dept Of Labor $248 111%
Us Department Of Labor $248 111%
Novanet Work Comp Tn $302 135%
Occunet Work Comp Tn $305 136%
Tn Work Comp $305 136%
Ambetter / Centene $368 164%
Node Point Comfort Underwriters $368 164%
Cigna $427 - $458 191%
Multiplan $580 - $762 259%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7565 Dannaher Way Powell, Powell, TN 37849
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals