CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Texas Health Presbyterian Hospital Rockwall

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $299
  • Cash Discount Price: $311
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Texas Health Presbyterian Hospital Rockwall is $299. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $311. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.34x the Medicare baseline. Located in 3150 Horizon Road, Rockwall, TX.
Cash / Self-Pay
$311

Average discount available for prompt cash payment at this facility.

Insurance Median
$299

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: $311 (139%)
Insurance Median: $299 (134%)
Cash: $311 (139% of Medicare)
Ins. Median: $299 (134% 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
Amerigroup $50 - $231 22%
Blue Cross Blue Shield $50 - $1,511 22%
Parkland $50 22%
UnitedHealthcare $50 - $764 22%
Superior Wellcare $52 - $242 23%
Molina $54 - $231 24%
Aetna $213 - $363 95%
American Health $220 98%
Healthspring $224 100%
Fort Worth Firefighters $228 - $316 102%
Humana $229 102%
City Of Fort Worth $243 109%
Cigna $286 - $487 128%
Quick Trip $311 - $326 139%
Phcs $360 - $386 161%
Healthsmart $388 - $435 173%
Multiplan $451 202%
Galaxy $456 204%
Usa $456 204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3150 Horizon Road, Rockwall, TX 75032
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals