CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Houston Healthcare West

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $98
  • Cash Discount Price: $244
  • vs. Medicare Baseline: 0.44x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Houston Healthcare West is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $244. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.44x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
$244

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $244 (109%)
Insurance Median: $98 (44%)
Cash: $244 (109% of Medicare)
Ins. Median: $98 (44% 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 $15 7%
Community Health Choice Mcd $32 14%
Amerigroup $34 15%
Cigna $36 - $195 16%
Texas Childrens Health Plans $40 - $58 18%
United $41 - $110 18%
Oscar $48 21%
Texas Workforce Commission $59 26%
Healthcare Highways $62 28%
Aetna $65 - $106 29%
Evry Health $67 30%
Blue Cross Blue Shield $85 - $740 38%
Imagine Health $85 38%
Christus (Usfhp) $98 44%
Curative Administrators $98 44%
Healthsmart Preferred Care $105 - $207 47%
Averde Health $110 49%
Fidelis Securecare Of Tx $110 49%
Coventry National First Health $130 58%
Physicians Cooperative Of Texas $134 60%
Rockport Workers Comp $134 60%
Independent Medical System $146 65%
National Healthcare Solutions $146 65%
Southwest Medical $146 65%
Triumph $146 65%
Coastal Comp $159 71%
Humana $174 78%
Multiplan $183 - $207 82%
Physicians, Inc $207 93%
Affiliated Ppo $220 98%
Texas Athletic Network $300 - $600 134%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals