CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Houston Healthcare Southeast

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $176
  • Cash Discount Price: $407
  • vs. Medicare Baseline: 0.79x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Houston Healthcare Southeast is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.79x the Medicare baseline. Located in 4000 Spencer Hwy, Pasadena, TX.
Cash / Self-Pay
$407

Average discount available for prompt cash payment at this facility.

Insurance Median
$176

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: $407 (182%)
Insurance Median: $176 (79%)
Cash: $407 (182% of Medicare)
Ins. Median: $176 (79% 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
Superior Health Plan $24 11%
Community Health Choice Mcd $53 24%
Amerigroup $57 25%
Texas Childrens Health Plans $72 - $96 32%
Oscar $79 35%
United $82 - $183 37%
Texas Workforce Commission $98 44%
Aetna $108 - $176 48%
Blue Cross Blue Shield $142 - $635 63%
Christus (Usfhp) $163 73%
Humana $174 78%
Healthsmart Preferred Care $175 - $346 78%
Averde Health $183 82%
Fidelis Securecare Of Tx $183 82%
Multiplan $203 - $366 91%
Coventry National First Health $217 97%
Physicians Cooperative Of Texas $224 100%
Rockport Workers Comp $224 100%
Beech Street $244 - $325 109%
Independent Medical System $244 109%
National Healthcare Solutions $244 109%
Prime Health Services $244 109%
Southwest Medical $244 109%
Coastal Comp $264 118%
Texas Athletic Network $300 - $600 134%
Fiesta Mart, Inc $305 136%
Cigna $325 145%
Physicians, Inc $346 155%
Affiliated Ppo $366 164%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4000 Spencer Hwy, Pasadena, TX 77504
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals