CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Intermountain Health Heber Valley Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $111
Cash Discount Price: $96
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Intermountain Health Heber Valley Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.50x the Medicare baseline. Located in 454 East Medical Way, Heber City, UT.

Cash / Self-Pay

$96

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $96 (43%)

Insurance Median: $111 (50%)

Cash: $96 (43% of Medicare)

Ins. Median: $111 (50% 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
Triwest	$8 - $96	4%
Aetna	$38 - $112	17%
American Health	$38	17%
Blue Cross Blue Shield	$38 - $113	17%
Health Partners Of Nevada	$38	17%
Health Plan Of Nevada	$38 - $113	17%
Healthy U	$38 - $113	17%
Humana	$38	17%
Molina	$38 - $113	17%
Selecthealth	$38 - $113	17%
UnitedHealthcare	$38 - $113	17%
Corporation Of The President	$96	43%
Corvel Corporation	$96	43%
Injury Care Of Nevada	$96	43%
Wcf Insurance	$96	43%
Byu Risk Management	$108	48%
Cigna	$108 - $113	48%
Medcare International	$108	48%
Springtide	$108	48%
Uofu	$108	48%
Byu Athletics	$111	50%
Campbell Scientific	$111	50%
Emi Health	$111	50%
Franklin County	$111	50%
Ifit	$111	50%
Juniper Systems	$111	50%
Lw Miller	$111	50%
Managed Care Admin	$111	50%
Motivhealth	$111	50%
Prodegi Corp Benefit	$111	50%
Tanner Llc	$111	50%
Utah Tech	$111	50%
Wise Network	$111	50%
Awh Connected	$113 - $114	51%
Deseret Mutual	$113	51%
Emi	$113	51%
Intermountain Caregiver Plan	$113	51%
Pehp	$113 - $115	51%
Global Excel	$115	51%
Health Utah	$115	51%
Hygeia Corporation	$115	51%

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 $96.
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 Intermountain Health Heber Valley 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.