CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: University of Texas M. D. Anderson Cancer Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $193
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at University of Texas M. D. Anderson Cancer Center is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.86x the Medicare baseline. Located in 1515 Holcombe Blvd, Houston, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$193

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%)

Insurance Median: $193 (86%)

Ins. Median: $193 (86% 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
Tricare	$7 - $244	3%
UnitedHealthcare	$14 - $244	6%
Blue Cross Blue Shield	$16 - $235	7%
Aetna	$22 - $244	10%
Humana	$50 - $251	22%
Cigna	$54 - $244	24%
Ontarioministriesofhealth	$62 - $241	28%
Beijingst.Lucia	$63 - $244	28%
Embassyofqatar	$63 - $244	28%
Memorialhermannhealth	$63 - $244	28%
Emergingtherapysolutions_Cancercare	$67 - $261	30%
Interlink_Cancercare	$67 - $261	30%
Saudiarmedforces	$67 - $261	30%
Uae_Medical	$67 - $261	30%
Uaepoliceattache	$67 - $261	30%
Healthsmart	$71 - $277	32%
Vantage	$71 - $277	32%
Texaschildrens	$81 - $143	36%
Multiplan	$88 - $280	39%
Phcs	$88 - $280	39%
Medicare (plans)	$106 - $143	47%
Vacare	$106 - $334	47%
Emergingtherapysolutions	$181 - $261	81%
Interlink	$181 - $277	81%

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 $X.
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 University of Texas M. D. Anderson Cancer Center 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.