CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: North Texas Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $203
  • Cash Discount Price: $63
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at North Texas Medical Center is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.91x the Medicare baseline. Located in 1900 Hospital Blvd, Gainesville, TX.
Cash / Self-Pay
$63

Average discount available for prompt cash payment at this facility.

Insurance Median
$203

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: $63 (28%)
Insurance Median: $203 (91%)
Cash: $63 (28% of Medicare)
Ins. Median: $203 (91% 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
Cigna $29 - $173 13%
Blue Cross Blue Shield $36 - $216 16%
First Health $43 - $259 19%
Healthcare Highways $43 - $259 19%
Aetna $45 - $268 20%
Multiplan $50 - $302 22%
Provider Select $61 - $367 27%
Prime Health $65 - $389 29%
UnitedHealthcare $66 - $397 30%
90 Degree Benefits $203 91%
Humana $203 91%
Molina $203 - $224 91%
Prominence Health $203 - $213 91%
Superior $203 - $224 91%
Wellmed $203 91%
Wellpoint $203 91%
Providers Partners Health Plan $213 95%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Hospital Blvd, Gainesville, TX 76240
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals