CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Methodist Rehabilitation Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $91
Cash Discount Price: $95
vs. Medicare Baseline: 0.41x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Methodist Rehabilitation Hospital is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.41x the Medicare baseline. Located in 3020 West Wheatland Road, Dallas, TX.

Cash / Self-Pay

$95

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $95 (42%)

Insurance Median: $91 (41%)

Cash: $95 (42% of Medicare)

Ins. Median: $91 (41% 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
Humana	$56 - $170	25%
Group And Pension Administrators (Under Multiplan) (Primary)	$58 - $131	26%
Multiplan (Pchs)	$58 - $131	26%
Multiplan	$63 - $143	28%
Aetna	$75 - $170	34%
Ambetter / Centene	$75 - $170	34%
Amerigroup	$75 - $170	34%
Blue Cross Blue Shield	$75 - $170	34%
Cigna	$75 - $170	34%
Friday Health Commercial (Ppo & Epo)	$75 - $170	34%
Healthcare Highways	$75 - $170	34%
Healthscope	$75 - $170	34%
Medicare (plans)	$75 - $170	34%
Molina Exchange	$75 - $170	34%
Oscar Healthcare	$75 - $170	34%
Scott & White Health Plan	$75 - $170	34%
Southwestern Health Resources (Paid Under United Hc)	$75 - $170	34%
Superior	$75 - $170	34%
Texas Plus (Universal American)(Includes Wellcare - Merged With Texan Plus Eff 1/1/19)	$75 - $170	34%
UnitedHealthcare	$75 - $170	34%
Wellmed	$75 - $170	34%

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 $95.
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 Methodist Rehabilitation Hospital 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.