CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Lincoln Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $64
Cash Discount Price: $68
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Lincoln Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.29x the Medicare baseline. Located in 10 Nichols Street, Davenport, WA.

Cash / Self-Pay

$68

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $68 (30%)

Insurance Median: $64 (29%)

Cash: $68 (30% of Medicare)

Ins. Median: $64 (29% 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
Ambetter / Centene	$15 - $602	7%
Labor & Industries - All Plans	$15	7%
Molina Hlthy Options	$15 - $602	7%
UnitedHealthcare	$15 - $1,132	7%
Amerigroup Mcaid - All Plans	$16 - $638	7%
Aetna	$19 - $1,222	8%
Indian Hlth Services - All Plans	$19 - $720	8%
Tricare	$19 - $720	8%
Va Ccn - All Plans	$19 - $720	8%
Cigna	$25 - $981	11%
Focus Healthcare Mgmt - All Plans	$26 - $1,029	12%
Molina Exchange-All Other Plans	$27 - $1,023	12%
Blue Cross Blue Shield	$29 - $1,132	13%
First Health Coventry-All Plans	$29 - $1,144	13%
Uniform Medical Plan-All Plans	$29 - $1,132	13%
Asuris Nw Health-All Plans	$30 - $1,183	13%
Health Management Network-All Plans	$30 - $1,157	13%
Three Rivers-All Plans	$30 - $1,157	13%
Multiplan-All Plans	$31 - $1,222	14%
Physician Hosp Comm Org-All Plans	$31 - $1,222	14%
First Choice Health- All Plans	$32 - $1,247	14%

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 $68.
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 Lincoln 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.