CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Baylor Scott & White Medical Center Hillcrest

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $217
  • Cash Discount Price: $225
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Baylor Scott & White Medical Center Hillcrest is $217. 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 0.97x the Medicare baseline. Located in 100 Hillcrest Medical Blvd, Waco, TX.
Cash / Self-Pay
$225

Average discount available for prompt cash payment at this facility.

Insurance Median
$217

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: $217 (97%)
Cash: $225 (101% of Medicare)
Ins. Median: $217 (97% 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 $45 20%
Texas Workforce Commission $124 55%
Baylor Scott & White Health Plan $136 - $322 61%
UnitedHealthcare $166 - $241 74%
Cigna $193 - $226 86%
Humana $195 - $262 87%
Triwest $195 87%
Corvel $204 91%
Prime Health Services $204 91%
American Health Plan $205 92%
Blue Cross Blue Shield $205 - $636 92%
Procare Advantage $205 92%
Aetna $206 92%
Midcoast $206 92%
Quiktrip $206 92%
University Of Mary Hardin-Baylor $217 97%
Independent Medical System $225 101%
Imagine Health $235 105%
Injury Management Organization $242 108%
Curative $244 109%
First Health $262 117%
Healthsmart $262 - $281 117%
Private Health Care System $281 126%
Sedgwick $292 131%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Hillcrest Medical Blvd, Waco, TX 76712
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals