CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Medical City Las Colinas

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $278
Cash Discount Price: $532
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Medical City Las Colinas is $278. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $532. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.24x the Medicare baseline. Located in 6800 N Macarthur Blvd, Irving, TX.

Cash / Self-Pay

$532

Average discount available for prompt cash payment at this facility.

Insurance Median

$278

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: $532 (238%)

Insurance Median: $278 (124%)

Cash: $532 (238% of Medicare)

Ins. Median: $278 (124% 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	$35 - $47	16%
Aetna	$68 - $493	30%
Cigna	$68 - $95	30%
United	$90 - $120	40%
Oscar	$105 - $141	47%
Humana	$128	57%
Healthcare Highways	$171 - $228	76%
Unicare	$177 - $676	79%
Blue Cross Blue Shield	$225 - $984	101%
City Of Mckinney	$228 - $304	102%
National Choicecare	$253 - $338	113%
Pc Texas Partners	$278 - $372	124%
Physicians Coop Of Tx	$278 - $372	124%
Rockport Health Group	$278 - $372	124%
Averde Health, Inc	$293 - $392	131%
Coastal Comp Health Networks	$354 - $473	158%
Mega Life	$354 - $473	158%
Multiplan Phcs	$354 - $473	158%
Healthsmart Preferred Care	$359 - $480	160%
Lewisville Isd/Dls Consulting	$380 - $507	170%
Usa Managed Care	$405 - $541	181%
Usc Health Services	$405 - $541	181%
Galaxy Health Network	$430 - $574	192%
Independent Medical Systems	$506 - $676	226%
National Healthcare Solutions	$506 - $676	226%

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 $532.
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 Las Colinas 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.