CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Houston Healthcare Conroe

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $249
Cash Discount Price: $622
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Houston Healthcare Conroe is $249. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $622. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.11x the Medicare baseline. Located in 504 Medical Center Blvd, Conroe, TX.

Cash / Self-Pay

$622

Average discount available for prompt cash payment at this facility.

Insurance Median

$249

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: $622 (278%)

Insurance Median: $249 (111%)

Cash: $622 (278% of Medicare)

Ins. Median: $249 (111% 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
Superior Health Plan	$37	17%
Community Health Choice Mcd	$81	36%
Amerigroup	$87	39%
United	$109 - $280	49%
Oscar	$121	54%
Texas Childrens Health Plans	$127 - $147	57%
Tx Workforce Commission	$149	67%
Aetna	$165 - $269	74%
Humana	$174	78%
Blue Cross Blue Shield	$218 - $616	97%
Christus (Usfhp)	$249	111%
Healthsmart Preferred Care	$267 - $529	119%
Averde Health	$280	125%
Fidelis Securecare Of Tx	$280	125%
Texas Athletic Network	$300 - $600	134%
Coventry National First Health	$332	148%
Physicians Cooperative Of Texas	$342	153%
Rockport Workers Comp	$342	153%
Independent Medical System	$373	167%
National Healthcare Solutions	$373	167%
Southwest Medical	$373	167%
Coastal Comp	$404	181%
Multiplan	$466 - $529	208%
Physicians, Inc	$529	236%
Affiliated Ppo	$560	250%

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 $622.
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 HCA Houston Healthcare Conroe 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.