CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Christus Santa Rosa Hospital-San Marcos

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $213
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Christus Santa Rosa Hospital-San Marcos is $213. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.95x the Medicare baseline. Located in 1301 Wonder World Drive, San Marcos, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$213

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%)
Insurance Median: $213 (95%)
Ins. Median: $213 (95% 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
Humana $71 - $197 32%
Allwell $197 88%
Christus Health $197 - $276 88%
Triwest $197 88%
UnitedHealthcare $197 - $518 88%
Washington National $197 88%
Wellcare $197 88%
Aetna $201 90%
Cigna $203 - $411 91%
Provider Partners Health Plan $203 91%
Shared Health Insurance Company $207 93%
Amerigroup $213 95%
Devoted Health Plan $213 95%
Sendero $337 151%
Naphcare Inc. $394 176%
Blue Cross Blue Shield $449 - $773 201%
Healthcare Highways $499 223%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1301 Wonder World Drive, San Marcos, TX 78666
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals