CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Medical City Fort Worth

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $209
Cash Discount Price: $417
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Medical City Fort Worth is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $417. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.93x the Medicare baseline. Located in 900 Eighth Avenue, Fort Worth, TX.

Cash / Self-Pay

$417

Average discount available for prompt cash payment at this facility.

Insurance Median

$209

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: $417 (186%)

Insurance Median: $209 (93%)

Cash: $417 (186% of Medicare)

Ins. Median: $209 (93% 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	$20 - $53	9%
Cigna	$38 - $401	17%
Aetna	$46 - $446	21%
United	$54 - $142	24%
Oscar	$59 - $157	26%
Unicare	$63 - $757	28%
Healthcare Highways	$96 - $256	43%
Blue Cross Blue Shield	$127 - $984	57%
City Of Mckinney	$128 - $341	57%
Fidelis Securecare	$128 - $341	57%
Humana	$128	57%
Emerging Therapy Solutions	$143 - $545	64%
National Choicecare	$143 - $378	64%
Pc Texas Partners	$157 - $416	70%
Physicians Coop Of Tx	$157 - $416	70%
Rockport Health Group	$157 - $416	70%
Averde Health, Inc	$165 - $439	74%
Coastal Comp Health Networks	$200 - $530	89%
Mega Life	$200 - $530	89%
Multiplan Phcs	$200 - $530	89%
Healthsmart Preferred Care	$202 - $537	90%
Lewisville Isd/Dls Consulting	$214 - $568	96%
Tcu Athletics	$228 - $605	102%
Usa Managed Care	$228 - $605	102%
Usc Health Services	$228 - $605	102%
Galaxy Health Network	$242 - $643	108%
UnitedHealthcare	$245 - $651	110%
Independent Medical Systems	$285 - $757	127%
National Healthcare Solutions	$285 - $757	127%

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 $417.
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 Fort Worth 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.