CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Texas Childrens Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $246
  • Cash Discount Price: $258
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Texas Childrens Hospital is $246. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $258. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.10x the Medicare baseline. Located in 6621 Fannin Street, Houston, TX.
Cash / Self-Pay
$258

Average discount available for prompt cash payment at this facility.

Insurance Median
$246

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: $258 (115%)
Insurance Median: $246 (110%)
Cash: $258 (115% of Medicare)
Ins. Median: $246 (110% 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
First Care Health Plan $104 - $247 46%
UnitedHealthcare $104 - $247 46%
Driscoll Children'S Health Plan Mcd $115 - $116 51%
Molina Mcd $115 - $116 51%
Blue Cross Blue Shield $134 - $243 60%
Community Health Choice $136 - $247 61%
Community First Health Plan Mcd $154 69%
Cook Children'S Health Plan $154 69%
Cigna $219 - $247 98%
Aetna $246 - $247 110%
Kelseycare $250 - $251 112%
Healthsmart $269 - $270 120%
Evolutions Healthcare $288 - $290 129%
First Health $338 - $367 151%
Multiplan $346 - $347 155%
Galaxy Health Network $365 - $367 163%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6621 Fannin Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens