CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Tristar Stonecrest Medical Center

Billing Code: 94640 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$113

about 0.5× the $224 Medicare rate · typically $19–$279

modeled estimate · not a bill or quote

Medicare pays $224 Fair price $113 Cash price $330 Hospital's list price $330

How we calculate the fair BaseRate →

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	$58 - $225	26%
Blue Cross Blue Shieldmajor	$15 - $36	7%
Aetnamajor	$45 - $250	20%
Cignamajor	$41 - $163	18%
Humanamajor	$40 - $125	18%
Ambetter (Centene)	$36 - $116	16%
Bright Health	$27 - $120	12%
Health Net	$113 - $349	51%
Oscar Health	$30 - $91	13%
+ 6 smaller / regional plans	$30 - $424

Excludes 2 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 330), 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 Tristar Stonecrest 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 Tristar Stonecrest Medical Center

Compare: Breathing treatment (nebulizer) at other TN hospitals

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