CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Saint Thomas Highlands Hospital

Billing Code: 94640 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$180

about 0.8× the $224 Medicare rate · typically $50–$228

modeled estimate · not a bill or quote

What this hospital charges insurers

$192

About the fair price

about $12 over the fair price · 0.9× Medicare

Medicare pays $224 Fair price $180 This hospital $192 Cash price $76 Hospital's list price $252

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 $192

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 $180 (about 0.8× the $224 Medicare rate). Saint Thomas Highlands Hospital charges insurers about $192, or about $76 in cash — about the fair price. Located in Sparta, TN.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$192	86%
Blue Cross Blue Shieldmajor	$13 - $202	6%
Aetnamajor	$196	88%
Humanamajor	$192	86%
Ambetter (Centene)	$250	112%
Amerigroup	$192	86%
Cigna HealthSpring	$192	86%
Oscar Health	$269	120%
+ 6 smaller / regional plans	$15 - $269

Government programs also on file: Medicare.

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 76), 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 Saint Thomas Highlands Hospital 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 Saint Thomas Highlands Hospital

Compare: Breathing treatment (nebulizer) at other TN hospitals

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