CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Cook Childrens Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $197
  • Cash Discount Price: $326
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Cook Childrens Medical Center is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $326. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.88x the Medicare baseline. Located in 801 Seventh Avenue, Fort Worth, TX.
Cash / Self-Pay
$326

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

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: $326 (146%)
Insurance Median: $197 (88%)
Cash: $326 (146% of Medicare)
Ins. Median: $197 (88% 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
Health Plan W. Uhrip $8 - $601 4%
Health Plan W/O Uhrip $8 - $379 4%
Aetna $11 - $1,028 5%
Beacon $17 - $532 8%
Firstcare $17 - $1,265 8%
Rightcare $23 - $532 10%
Molina $26 - $585 12%
El Paso Health First $31 - $696 14%
Tx Children Health $31 - $696 14%
United Community $40 - $425 18%
Wellpoint $40 - $425 18%
UnitedHealthcare $41 - $1,344 18%
Blue Cross Blue Shield $42 - $1,328 19%
Superior Health $51 - $532 23%
Cigna $59 - $1,344 26%
Healthscope $59 - $1,344 26%
Imagine Health $59 - $1,344 26%
S&W Health $59 - $1,328 26%
Humana $61 - $1,391 27%
Multiplan $61 - $1,375 27%
First Health $62 - $1,391 28%
Galaxy Health $63 - $1,423 28%
Usamco $64 - $1,454 29%
Healthsmart $104 - $1,088 46%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 801 Seventh Avenue, Fort Worth, TX 76104
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens