CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Medical City Plano

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $264
  • Cash Discount Price: $523
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Medical City Plano is $264. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $523. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.18x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
$523

Average discount available for prompt cash payment at this facility.

Insurance Median
$264

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: $523 (234%)
Insurance Median: $264 (118%)
Cash: $523 (234% of Medicare)
Ins. Median: $264 (118% 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 $31 - $72 14%
Cigna $60 - $144 27%
Aetna $72 - $622 32%
United $77 - $179 34%
Oscar $92 - $214 41%
Humana $128 57%
Lifecare Hospitals $133 - $308 59%
Healthcare Highways $150 - $348 67%
Prominence Health Plan $178 - $411 80%
Blue Cross Blue Shield $197 - $984 88%
City Of Mckinney $200 - $463 89%
Fidelis Securecare $200 - $463 89%
National Choicecare $222 - $514 99%
Pc Texas Partners $244 - $566 109%
Physicians Coop Of Tx $244 - $566 109%
Rockport Health Group $244 - $566 109%
Averde Health, Inc $258 - $596 115%
Texas Healthcare Foundation Wc $289 - $668 129%
Coastal Comp Health Networks $311 - $720 139%
Mega Life $311 - $720 139%
Multiplan Phcs $311 - $720 139%
Healthsmart Preferred Care $333 - $771 149%
Lewisville Isd/Dls Consulting $333 - $771 149%
Usa Managed Care $355 - $823 159%
Usc Health Services $355 - $823 159%
Galaxy Health Network $378 - $874 169%
Independent Medical Systems $444 - $1,028 198%
National Healthcare Solutions $444 - $1,028 198%
Unicare $444 - $1,028 198%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals