CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Medical Center of McKinney

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $272
  • Cash Discount Price: $595
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Medical Center of McKinney is $272. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $595. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.22x the Medicare baseline. Located in 4500 Medical Center Drive, McKinney, TX.
Cash / Self-Pay
$595

Average discount available for prompt cash payment at this facility.

Insurance Median
$272

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: $595 (266%)
Insurance Median: $272 (122%)
Cash: $595 (266% of Medicare)
Ins. Median: $272 (122% 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 $28 - $55 13%
Aetna $54 - $575 24%
Cigna $54 - $633 24%
United $75 - $148 34%
Oscar $83 - $164 37%
Unicare $104 - $791 46%
Humana $128 - $514 57%
Healthcare Highways $135 - $267 60%
City Of Mckinney $140 - $277 63%
Blue Cross Blue Shield $177 - $984 79%
Fidelis Securecare $180 - $356 80%
National Choicecare $200 - $395 89%
Pc Texas Partners $220 - $435 98%
Physicians Coop Of Tx $220 - $435 98%
Rockport Health Group $220 - $435 98%
Averde Health, Inc $232 - $459 104%
Magellan Bh $240 - $474 107%
Value Options Behavioral Health $240 - $474 107%
Coastal Comp Health Networks $280 - $554 125%
Mega Life $280 - $554 125%
Multiplan Phcs $280 - $554 125%
Lewisville Isd/Dls Consulting $300 - $593 134%
Compsych Corporation $320 - $633 143%
Healthsmart Preferred Care $320 - $633 143%
Usa Managed Care $320 - $633 143%
Galaxy Health Network $340 - $672 152%
Independent Medical Systems $400 - $791 179%
National Healthcare Solutions $400 - $791 179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4500 Medical Center Drive, McKinney, TX 75069
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals