CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Las Palmas Medical Center A Campus of Lpds Healthc

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $142
Cash Discount Price: $476
vs. Medicare Baseline: 0.63x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Las Palmas Medical Center A Campus of Lpds Healthc is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $476. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.63x the Medicare baseline. Located in 1801 North Oregon Street, El Paso, TX.

Cash / Self-Pay

$476

Average discount available for prompt cash payment at this facility.

Insurance Median

$142

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: $476 (213%)

Insurance Median: $142 (63%)

Cash: $476 (213% of Medicare)

Ins. Median: $142 (63% 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
El Paso First Health Plans	$9 - $34	4%
Superior Health Plan	$9 - $37	4%
Oscar	$16 - $63	7%
Cigna	$17 - $66	8%
Bienvivir Senior Health	$26 - $104	12%
Healthcare Highways	$29 - $118	13%
United	$42 - $276	19%
Aetna	$47 - $349	21%
First Health	$69 - $276	31%
Healthsmart Preferred Care	$69 - $337	31%
Emerging Therapy Solutions	$70 - $423	31%
Sheriff'S Dept El Paso County Detention	$76 - $306	34%
Ysleta Del Sur Pueblo	$76 - $306	34%
Southwest Medical Provider Network	$84 - $337	38%
Advantage Care Network	$92 - $368	41%
El Paso First Health Plan	$92 - $368	41%
Prime Health	$92 - $368	41%
Texas Workforce Commission	$96 - $386	43%
Multiplan	$99 - $398	44%
Phcs	$99 - $398	44%
Integrated Medical Systems	$107 - $429	48%
Samsa	$107 - $429	48%
Danmark - International Contract	$115 - $460	51%
Galaxy Health Network	$115 - $460	51%
Medcorp Southwest	$122 - $490	55%
Usa Managed Care	$125 - $582	56%
Affiliated Healthcare	$130 - $521	58%
National Provider Network	$138 - $552	62%
Blue Cross Blue Shield	$811 - $1,385	363%

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 $476.
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 Las Palmas Medical Center A Campus of Lpds Healthc 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.