CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Methodist Mansfield Medical Center
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $223
- Cash Discount Price: $109
- vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Methodist Mansfield Medical Center is $223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.00x the Medicare baseline. Located in 2700 E Broad Street, Mansfield, TX.
Cash / Self-Pay
$109
Average discount available for prompt cash payment at this facility.
Insurance Median
$223
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: $109 (49%)
Insurance Median: $223 (100%)
Cash: $109 (49% of Medicare)
Ins. Median: $223 (100% 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $10 - $236 | 4% |
| Medicaid / KanCare | $37 - $97 | 17% |
| Blue Cross Blue Shield | $121 - $247 | 54% |
| Aetna | $220 - $357 | 98% |
| Community Hospice Of Texas [2005] | $220 | 98% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [6005] | $220 | 98% |
| Faith Hospice [2008] | $220 | 98% |
| Generic Hospice [2011] | $220 | 98% |
| Heart To Heart Hospice [2012] | $220 | 98% |
| Homebound Cardinal Hospice [4019] | $220 | 98% |
| Hospice Plus [2013] | $220 | 98% |
| Kindful Health Hospice [4016] | $220 | 98% |
| Lions Hospice [2015] | $220 | 98% |
| Medicare (plans) | $220 - $236 | 98% |
| New Century Hospice [2003] | $220 | 98% |
| Odyssey Hospice [2018] | $220 | 98% |
| Silverado Hospice [4017] | $220 | 98% |
| Ust Health Proof [1005] | $220 | 98% |
| Vista Care Hospice [2023] | $220 | 98% |
| Vitas Hospice [2024] | $220 | 98% |
| Vna Hospice [2025] | $220 | 98% |
| Wellcare [7016] | $220 | 98% |
| American Health Advantage Of Texas [7099] | $231 | 103% |
| Cigna | $231 - $408 | 103% |
| Globalhealth [1003] | $231 | 103% |
| Procare Advantage [7018] | $231 | 103% |
| Humana | $234 | 105% |
| Southwestern Health Resources Swhr [7015] | $234 | 105% |
| Provider Partners Health Plan [7025] | $238 | 106% |
| Alternative Service Concepts [8005] | $275 | 123% |
| Oscar Insurance Company [2057] | $286 | 128% |
| Bright Healthcare [2222] | $308 | 138% |
| Molina [3017] | $319 | 143% |
| Wellpoint Marketplace Exchange [3071] | $342 | 153% |
| Kempton Group Administrators, Tower Extrusions [3061] | $353 | 158% |
| 90 Degree Benefit [3057] | $364 | 163% |
| Allied National [2031] | $364 | 163% |
| Entrust/90 Degree [2058] | $364 | 163% |
| Friday Health Plan [2061] | $375 | 168% |
| Ambetter / Centene | $377 | 169% |
| Imperial Insurance Companies [3073] | $397 | 177% |
| Web Tpa [3049] | $408 | 182% |
| Department Of Labor [8004] | $441 | 197% |
| Evry Health [1013] | $441 | 197% |
| Generic Workers Comp Tx Non Par [9010] | $441 | 197% |
| Generic Workers Comp Tx Par [8002] | $441 | 197% |
| Generic Workers Comp Tx Par [9011] | $441 | 197% |
| Sana Benefits [3069] | $441 | 197% |
| Tristar Risk Management [8006] | $441 | 197% |
| Velocity [3070] | $441 | 197% |
| Health Plans Inc [5017] | $551 | 246% |
| Medical Cost Containment Professionals [3059] | $551 | 246% |
| Dart Member Care [3039] | $595 | 266% |
| Healthscope Benefits [2052] | $595 | 266% |
| Healthscope Benefits [3063] | $595 | 266% |