CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Round Rock Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $157
  • Cash Discount Price: $430
  • vs. Medicare Baseline: 0.70x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Round Rock Medical Center is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $430. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.70x the Medicare baseline. Located in 2400 Round Rock Ave, Round Rock, TX.
Cash / Self-Pay
$430

Average discount available for prompt cash payment at this facility.

Insurance Median
$157

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: $430 (192%)
Insurance Median: $157 (70%)
Cash: $430 (192% of Medicare)
Ins. Median: $157 (70% 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 $9 - $132 4%
Amerigroup $12 5%
Oscar $36 - $166 16%
Moda $44 - $182 20%
United $47 - $349 21%
Covenant Management Systems $54 - $223 24%
Healthcare Highways $55 - $233 25%
Imo Med - Select Network $56 - $233 25%
Blue Cross Blue Shield $60 - $1,058 27%
Cigna $60 - $318 27%
Moda Health $68 - $287 30%
Texas Healthcare Foundation Heb $70 - $287 31%
Texas Workforce Commission $73 - $303 33%
Averde Health $85 - $349 38%
Comanche County $94 - $388 42%
National Choicecare $94 - $388 42%
Healthsmart Preferred Care $103 - $621 46%
Independent Medical Systems $103 - $427 46%
Physicians Cooperative Of Texas $103 - $427 46%
Prime Health $113 - $466 51%
First Health $118 - $558 53%
Coastal Comp Health Networks $122 - $504 55%
National Health Care $122 - $504 55%
Occunet $132 - $543 59%
Texas Municipal League $132 - $543 59%
Medcorp Southwest $141 - $582 63%
Preferred Health Arrangement $141 - $582 63%
Rockport Healthcare Group $150 - $698 67%
Bce Emergis Corporation $169 - $698 76%
Beech Street $169 - $698 76%
Medical Control Network Solutions $169 - $698 76%
Multiplan $169 - $698 76%
Aetna $7,657 - $12,950 3423%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 Round Rock Ave, Round Rock, TX 78681
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals