CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Physicians Regional Medical Center

Billing Code: 94640 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$186

about 0.8× the $224 Medicare rate · typically $39–$200

modeled estimate · not a bill or quote

What this hospital charges insurers

$201

About the fair price

about $15 over the fair price · 0.9× Medicare

Medicare pays $224 Fair price $186 This hospital $201 Cash price $238 Hospital's list price $1,074

How we calculate the fair BaseRate →

How this hospital compares to other TN hospitals

Highest price of the 9 TN hospitals we have prices for — worth calling around.

Cheapest $20 Priciest $201

Black dot = this hospital, among the 9 TN hospitals with a price for this procedure. Full list below.

A fair price for a Breathing treatment (nebulizer) is about $186 (about 0.8× the $224 Medicare rate). Physicians Regional Medical Center charges insurers about $201, or about $238 in cash — about the fair price. Located in Powell, TN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$65 - $1,074	29%
Blue Cross Blue Shieldmajor	$16 - $208	7%
Aetnamajor	$201 - $470	90%
Cignamajor	$427 - $458	191%
Humanamajor	$195	87%
Ambetter (Centene)	$368	164%
Amerigroup	$136 - $205	61%
Cigna HealthSpring	$201	90%
Devoted Health	$199	89%
WellCare	$207	93%
+ 7 smaller / regional plans	$195 - $368

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 238), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 94640.

Insurance Before you use insurance

Call your insurance company to confirm Physicians Regional Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 94640.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Physicians Regional Medical Center

Compare: Breathing treatment (nebulizer) at other TN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.