CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Medical City Lewisville

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $230
Cash Discount Price: $445
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Medical City Lewisville is $230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $445. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.03x the Medicare baseline. Located in 500 West Main Street, Lewisville, TX.

Cash / Self-Pay

$445

Average discount available for prompt cash payment at this facility.

Insurance Median

$230

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: $445 (199%)

Insurance Median: $230 (103%)

Cash: $445 (199% of Medicare)

Ins. Median: $230 (103% 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	$29 - $42	13%
Aetna	$56 - $439	25%
Cigna	$56 - $84	25%
United	$82 - $120	37%
Oscar	$86 - $126	38%
Unicare	$99 - $604	44%
Humana	$128	57%
Healthcare Highways	$140 - $204	63%
Blue Cross Blue Shield	$184 - $984	82%
City Of Mckinney	$186 - $272	83%
Fidelis Securecare	$186 - $272	83%
National Choicecare	$207 - $302	93%
Pc Texas Partners	$228 - $332	102%
Physicians Coop Of Tx	$228 - $332	102%
Rockport Health Group	$228 - $332	102%
Averde Health, Inc	$240 - $350	107%
Usc Health Services	$248 - $362	111%
Coastal Comp Health Networks	$290 - $423	130%
Jostens	$290 - $423	130%
Mega Life	$290 - $423	130%
Multiplan Phcs	$290 - $423	130%
Healthsmart Preferred Care	$311 - $453	139%
Lewisville Isd/Dls Consulting	$311 - $453	139%
Usa Managed Care	$331 - $483	148%
Galaxy Health Network	$352 - $513	157%
Independent Medical Systems	$414 - $604	185%
National Healthcare Solutions	$414 - $604	185%

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 $445.
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 Medical City Lewisville 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.