CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Lewisgale Hospital Pulaski

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $269
Cash Discount Price: $359
vs. Medicare Baseline: 1.20x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Lewisgale Hospital Pulaski is $269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $359. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.20x the Medicare baseline. Located in 2400 Lee Highway, Pulaski, VA.

Cash / Self-Pay

$359

Average discount available for prompt cash payment at this facility.

Insurance Median

$269

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: $359 (160%)

Insurance Median: $269 (120%)

Cash: $359 (160% of Medicare)

Ins. Median: $269 (120% 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
Lifeworks	$68	30%
Universal Healthcare Group	$79	35%
United	$120 - $162	54%
Virginia Health Network	$126 - $255	56%
Aetna	$129 - $162	58%
Greenvbrier Sporting Club	$215	96%
Corvel	$258	115%
Richfield Nursing Center	$269	120%
Richfield Retirement Community	$269	120%
Multiplan	$276	123%
Community Care Network	$287	128%
Graham-White Manufacturing	$287	128%
Occunet Workers Comp	$287	128%
One Health Plan	$287	128%
Patients Choice	$316	141%
4Most	$323	144%
American Postal Workers Union	$323	144%
Phcs	$323	144%
Star Transportation	$323	144%

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 $359.
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 Lewisgale Hospital Pulaski 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.