CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Carrollton Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $92
  • Cash Discount Price: $330
  • vs. Medicare Baseline: 0.41x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Carrollton Regional Medical Center is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $330. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.41x the Medicare baseline. Located in 4343 North Josey Lane, Carrollton, TX.
Cash / Self-Pay
$330

Average discount available for prompt cash payment at this facility.

Insurance Median
$92

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: $330 (148%)
Insurance Median: $92 (41%)
Cash: $330 (148% of Medicare)
Ins. Median: $92 (41% 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
Aetna $11 - $330 5%
Amerigroup $21 - $220 9%
Blue Cross Blue Shield $21 - $662 9%
Cigna $21 - $92 9%
Medicaid / KanCare $21 - $95 9%
Molina $21 - $227 9%
Superior $21 - $330 9%
Superior_Chip $21 - $92 9%
Uhc_Chip $21 - $92 9%
Uhc_Star $21 - $92 9%
Uhc_Star_Plus $21 - $92 9%
UnitedHealthcare $21 - $378 9%
Scott_And_White_Epo $75 - $329 34%
Scott_And_White_Hmo $75 - $329 34%
Scott_And_White_Ppo $75 - $329 34%
Scott_And_White_Swhp $75 - $329 34%
Phcs $113 - $493 51%
Humana $150 - $220 67%
Molina_Health_Insurance_Marketplace $150 - $286 67%
Molina_Star_Plus $150 - $227 67%
Scott_And_White $150 - $220 67%
Medicare (plans) $220 98%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4343 North Josey Lane, Carrollton, TX 75010
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals