CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Olympic Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $213
Cash Discount Price: $128
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Olympic Medical Center is $213. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.95x the Medicare baseline. Located in 939 Caroline St, Port Angeles, WA.

Cash / Self-Pay

$128

Average discount available for prompt cash payment at this facility.

Insurance Median

$213

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: $128 (57%)

Insurance Median: $213 (95%)

Cash: $128 (57% of Medicare)

Ins. Median: $213 (95% 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
Regence Uniform	$23 - $154	10%
Community Health Plan Of Washington	$34 - $234	15%
Ambetter / Centene	$38 - $262	17%
Cigna	$41 - $269	18%
Aetna	$42 - $276	19%
First Choice Network	$42 - $276	19%
Gmr/Caldera Care	$42 - $276	19%
Hma	$42 - $276	19%
Lifewise	$42 - $276	19%
Premera	$42 - $276	19%
Regence	$42 - $276	19%
UnitedHealthcare	$42 - $276	19%
Wellcare	$53	24%
Coordinated Care	$213	95%
Molina	$213 - $274	95%
Wellpoint (Formerly Amerigroup)	$224	100%

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 $128.
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 Olympic 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.