CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: UT Health East Texas Henderson Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $183
Cash Discount Price: $71
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at UT Health East Texas Henderson Hospital is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.82x the Medicare baseline. Located in 300 Wilson Street, Henderson, TX.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$183

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: $71 (32%)

Insurance Median: $183 (82%)

Cash: $71 (32% of Medicare)

Ins. Median: $183 (82% 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
Medicaid / KanCare	$103 - $183	46%
Amerigroup Commercial [5055]	$177	79%
Black Lung [6055]	$177	79%
Healthcare Highways [2210]	$177	79%
Healthscope Benefits [2290]	$177	79%
Lucent Health [6000]	$177	79%
Parkland Community Health Plan [6015]	$177	79%
Web Tpa [2115]	$177 - $442	79%
Blue Cross Blue Shield	$183	82%
UnitedHealthcare	$183	82%
Cigna	$395 - $467	177%
Aetna	$442	198%
Mailhandlers [1595]	$442	198%
Group Pension Admin [1450]	$467	209%
Humana	$467	209%
Phcs [1780]	$467	209%
Tml [1980]	$467	209%

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 $71.
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 UT Health East Texas Henderson Hospital 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.