CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Tristar Hendersonville Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $144
  • Cash Discount Price: $564
  • vs. Medicare Baseline: 0.64x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Tristar Hendersonville Medical Center is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $564. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.64x the Medicare baseline. Located in 355 New Shackle Island Rd, Hendersonville, TN.
Cash / Self-Pay
$564

Average discount available for prompt cash payment at this facility.

Insurance Median
$144

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: $564 (252%)
Insurance Median: $144 (64%)
Cash: $564 (252% of Medicare)
Ins. Median: $144 (64% 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 $15 - $132 7%
Bright Health $94 - $138 42%
Oscar $101 - $105 45%
Kentucky Labor Cabinet $102 - $106 46%
Apex Health $105 - $109 47%
Nhc Advantage, Inc. $105 - $109 47%
Pruitt Health (Allyalign) $105 - $109 47%
Ambetter / Centene $123 - $134 55%
Humana $138 - $144 62%
Cigna $139 - $194 62%
United $139 - $259 62%
Aetna $154 - $288 69%
Bgfh Singlesource $276 - $490 123%
Employers Health Network $386 - $403 173%
Odom'S Tn Pride Sausage $414 - $432 185%
Multiplan $452 - $472 202%
Beech Street $507 - $530 227%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 355 New Shackle Island Rd, Hendersonville, TN 37075
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals