CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Seton Medical Center Harker Heights

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $76
Cash Discount Price: $17
vs. Medicare Baseline: 0.34x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Seton Medical Center Harker Heights is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.34x the Medicare baseline. Located in 850 W Central Texas Expressway, Harker Heights, TX.

Cash / Self-Pay

$17

Average discount available for prompt cash payment at this facility.

Insurance Median

$76

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: $17 (8%)

Insurance Median: $76 (34%)

Cash: $17 (8% of Medicare)

Ins. Median: $76 (34% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicaid / KanCare	$12 - $180	5%
Blue Cross Blue Shield	$29 - $124	13%
Healthscope Benefits [2290]	$30	13%
UnitedHealthcare	$30 - $100	13%
Aetna	$31 - $96	14%
Bell County Indigent Health Svc [3530]	$32	14%
Healthcare Highways [2210]	$66	30%
Oncology Patient Assistance Programs [2295]	$66	30%
Selecthealth [3740]	$66	30%
Web Tpa [2115]	$66 - $134	30%
Oscar Exchange [6080]	$73	33%
Cigna	$76 - $145	34%
American Postal Workers Union [1070]	$79	35%
First Health [1375]	$96	43%
Mailhandlers [1595]	$96	43%
Geha [1415]	$100	45%
First Care Commercial [1371]	$126	56%
Allied Benefit Systems Inc [1030]	$134	60%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $17.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Seton Medical Center Harker Heights is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.