CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: North Texas Medical Center

Billing Code: 94640 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$166

about 0.7× the $224 Medicare rate · typically $25–$196

modeled estimate · not a bill or quote

What this hospital charges insurers

$184

About the fair price

about $18 over the fair price · 0.8× Medicare

Medicare pays $224 Fair price $166 This hospital $184 Cash price $63 Hospital's list price $252

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $24 Priciest $184

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

A fair price for a Breathing treatment (nebulizer) is about $166 (about 0.7× the $224 Medicare rate). North Texas Medical Center charges insurers about $184, or about $63 in cash — about the fair price. Located in Gainesville, TX.

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	$66 - $397	30%
Blue Cross Blue Shieldmajor	$36 - $216	16%
Aetnamajor	$45 - $268	20%
Cignamajor	$29 - $173	13%
Humanamajor	$203	91%
Healthcare Highways	$43 - $259	19%
Molina	$203 - $224	91%
WellMed	$203	91%
+ 5 smaller / regional plans	$61 - $367

Excludes 3 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 63), 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 North Texas 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 North Texas Medical Center

Compare: Breathing treatment (nebulizer) at other TX hospitals

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