CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Uva Health Haymarket Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $259
Cash Discount Price: $3,516
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Uva Health Haymarket Medical Center is $259. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,516. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.16x the Medicare baseline. Located in 15225 Healthcote Boulevard, Haymarket, VA.

Cash / Self-Pay

$3,516

Average discount available for prompt cash payment at this facility.

Insurance Median

$259

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: $3,516 (1572%)

Insurance Median: $259 (116%)

Cash: $3,516 (1572% of Medicare)

Ins. Median: $259 (116% 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
Champva [50002]	$9	4%
Tricare	$9	4%
Carefirst [30007]	$28 - $36	13%
Aetna	$114 - $3,896	51%
Cigna	$160 - $3,877	72%
Multiplan Generic [40035]	$182	81%
Vhn Generic [40040]	$182	81%
Sentara Behavioral Health [40052]	$186	83%
Sentara [40021]	$186	83%
Kaiser Permenente [40014]	$216	97%
Blue Cross Blue Shield	$227 - $11,928	101%
Medicare (plans)	$227 - $3,857	101%
UnitedHealthcare	$227 - $11,928	101%
VA Ccn [99926]	$227 - $3,857	101%
VA Ccn [99927]	$227 - $3,857	101%
Veterans Administration [99910]	$227 - $3,857	101%
Humana	$231 - $3,934	103%
Geha [40009]	$259	116%

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 $3,516.
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 Uva Health Haymarket Medical Center 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.