CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Spotsylvania Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $148
  • Cash Discount Price: $302
  • vs. Medicare Baseline: 0.66x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Spotsylvania Regional Medical Center is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $302. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.66x the Medicare baseline. Located in 4600 Spotsylvania Parkway, Fredericksburg, VA.
Cash / Self-Pay
$302

Average discount available for prompt cash payment at this facility.

Insurance Median
$148

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: $302 (135%)
Insurance Median: $148 (66%)
Cash: $302 (135% of Medicare)
Ins. Median: $148 (66% 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.

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
Bright Health $33 - $64 15%
Lifeworks $39 - $75 17%
United $58 - $179 26%
Aetna $72 - $139 32%
Virginia Health Network $72 - $258 32%
Kaiser $122 - $234 55%
Greenvbrier Sporting Club $124 - $238 55%
Multiplan $147 - $282 66%
Corvel $149 - $286 67%
Occunet Workers Comp $166 - $317 74%
4Most Health Nework $186 - $357 83%
Three Rivers Provider Network $186 - $357 83%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4600 Spotsylvania Parkway, Fredericksburg, VA 22408
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals