CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Baylor Scott & White Medical Center - Temple

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $233
Cash Discount Price: $225
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Baylor Scott & White Medical Center - Temple is $233. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.04x the Medicare baseline. Located in 2401 S 31St St, Temple, TX.

Cash / Self-Pay

$225

Average discount available for prompt cash payment at this facility.

Insurance Median

$233

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: $225 (101%)

Insurance Median: $233 (104%)

Cash: $225 (101% of Medicare)

Ins. Median: $233 (104% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Superior Health Plan	$56 - $198	25%
Texas Workforce Commission	$131	59%
Baylor Scott & White Health Plan	$136 - $326	61%
Cigna	$193 - $226	86%
Humana	$198 - $262	89%
Triwest	$198	89%
Aetna	$206	92%
Employers Health Network	$206	92%
Midcoast	$206	92%
Quiktrip	$206	92%
Corvel	$207	93%
Prime Health Services	$207	93%
American Health Plan	$208	93%
Blue Cross Blue Shield	$208 - $636	93%
Procare Advantage	$208	93%
University Of Mary Hardin-Baylor	$217	97%
Independent Medical System	$225	101%
UnitedHealthcare	$227 - $259	101%
Imagine Health	$235	105%
Curative	$244	109%
Injury Management Organization	$246	110%
First Health	$262	117%
Healthsmart	$262 - $281	117%
Bluebell Creameries	$281	126%
Private Health Care System	$281	126%
Careworks Fka Rockport	$296	132%
Sedgwick	$296	132%
Three Rivers	$337	151%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $225.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Baylor Scott & White Medical Center - Temple is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.