CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Franklin Woods Community 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 Franklin Woods Community 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 300 Med Tech Parkway, Johnson City, 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 $16 - $207 7%
UnitedHealthcare $27 - $363 12%
Cigna $49 - $305 22%
Optima Health $80 36%
Aetna $83 - $419 37%
Molina Healthcare $83 - $207 37%
Sentara Health $116 - $199 52%
Amerigroup $156 - $199 70%
First Health Coventry $199 89%
Humana $199 89%
Managed Medicaire $199 89%
Medicare (plans) $199 89%
United Mine Workers Of America $199 89%
Devoted Health Plan $209 93%
Nhc Advantage $209 93%
Wellcare $211 - $657 94%
Medcost $342 - $558 153%
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: 300 Med Tech Parkway, Johnson City, TN 37604
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals