CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Houston Healthcare Northwest

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $61
Cash Discount Price: $433
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Houston Healthcare Northwest is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $433. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.27x the Medicare baseline. Located in 710 Cypress Creek Parkway, Houston, TX.

Cash / Self-Pay

$433

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $433 (194%)

Insurance Median: $61 (27%)

Cash: $433 (194% of Medicare)

Ins. Median: $61 (27% 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	$5 - $28	2%
Community Health Choice Mcd	$12 - $61	5%
Cigna	$13 - $17	6%
Texas Childrens Health Plans	$15 - $111	7%
United	$15 - $210	7%
Oscar	$17 - $91	8%
Aetna	$22 - $185	10%
Healthcare Highways	$23	10%
Evry Health	$24	11%
Blue Cross Blue Shield	$31 - $594	14%
Christus (Usfhp)	$36 - $187	16%
Curative Administrators	$36	16%
Coventry National First Health	$48 - $249	21%
Humana	$174	78%

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 $433.
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 Northwest 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.