CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Memorial Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $43
  • Cash Discount Price: $33
  • vs. Medicare Baseline: 0.19x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Memorial Medical Center is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.19x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$33

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $33 (15%)
Insurance Median: $43 (19%)
Cash: $33 (15% of Medicare)
Ins. Median: $43 (19% 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
Ambetter / Centene $5 - $158 2%
Amerigroup Mcr Adv-All Other Plans $8 - $132 4%
Care Improvement Plus - All Other Plans $8 - $132 4%
Care Improvement Plus Mcr $8 - $133 4%
Superior Allwell Mcr Adv-All Other Plans $8 - $132 4%
Triwest Va Pccc-All Plans $8 - $129 4%
UnitedHealthcare $8 - $376 4%
Universal American Mcr-All Other Plans $8 - $132 4%
Universal American Snp $9 - $138 4%
Coventry First Hlth Hmo Ppo-All Other Plans $10 - $376 4%
Coventry First Hlth Mcr Adv $10 - $132 4%
Healthcare Highways-All Plans $11 - $376 5%
Galaxy Health Network-All Plans $12 - $400 5%
Prime Healthcare Services-All Plans $12 - $329 5%
Blue Cross Blue Shield $13 - $337 6%
Humana $13 - $376 6%
Capstar Health Network-All Plans $14 - $376 6%
Cigna $14 - $352 6%
Corvel Work Comp-All Plans $14 - $400 6%
Independent Med Sys Ppo-All Plans $14 - $400 6%
Multiplan Mcr Adv $14 - $132 6%
Multiplan Phcs Ppo-All Other Plans $14 - $400 6%
Provider Select Ppo-All Plans $14 - $400 6%
Three Rivers Ppo-All Plans $14 - $400 6%
Usa Mso - All Plans $14 - $400 6%
Amerigroup Chip $17 - $226 8%
Amerigroup Star $17 - $226 8%
Amerigroup Star Kids $17 - $226 8%
Amerigroup Star Plus $17 - $226 8%
Comm Health Chip $17 - $226 8%
Comm Health Perinatal-All Other Plans $17 - $226 8%
Molina Chip/Star-All Plans $17 - $226 8%
Scott & White Chip/Star-All Plans $17 - $226 8%
Superior Chip/Star $17 - $226 8%
Texas Childrens Hp - All Plans $17 - $226 8%
Comm Health Mcaid Hmo $18 - $237 8%
Comm Health Star $18 - $237 8%
Aetna $376 168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals