CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Russell County Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $222
Cash Discount Price: $79
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Russell County Hospital is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.99x the Medicare baseline. Located in 58 Carroll Street, Lebanon, VA.

Cash / Self-Pay

$79

Average discount available for prompt cash payment at this facility.

Insurance Median

$222

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: $79 (35%)

Insurance Median: $222 (99%)

Cash: $79 (35% of Medicare)

Ins. Median: $222 (99% 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
Blue Cross Blue Shield	$16 - $657	7%
UnitedHealthcare	$27 - $363	12%
Cigna	$49 - $305	22%
Optima Health	$74	33%
Molina Healthcare	$77 - $222	34%
Aetna	$78 - $526	35%
Medcost	$141 - $230	63%
Sentara Health	$146 - $239	65%
Amerigroup	$214	96%
Managed Medicaire	$214	96%
Medicare (plans)	$214	96%
United Mine Workers of America	$214	96%
Humana	$217	97%
Devoted Health Plan	$224	100%
Nhc Advantage	$224	100%
First Health Coventry	$402 - $657	180%
Seven Corners, Inc.	$402 - $657	180%
Ambetter / Centene	$466	208%

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 $79.
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 Russell County 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.