Breathing treatment (nebulizer)
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $96
- Cash Discount Price: $129
- vs. Medicare Baseline: 0.43x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $64 - $115 | 29% |
| Americas Choice Provider Network | $75 - $134 | 34% |
| Usa Managed Care Organization | $80 - $144 | 36% |
| Quiktrip Corporation | $80 - $144 | 36% |
| Provider Network Of America | $80 - $144 | 36% |
| Velocity | $80 - $144 | 36% |
| Multiplan-Phcs | $86 - $153 | 38% |
| Prime Health Services | $91 - $163 | 41% |
| Medincrease | $96 - $172 | 43% |
Consumer Guidance & Cost Commentary
For the CPT code 94640, representing a breathing treatment via nebulizer, the Rehabilitation Hospital Of Overland Park lists a cash price of $129.00. This cash rate is significantly lower than the facility's gross charge of $129.00, which appears to be the listed amount in this dataset. While the facility does not publish a specific state or county average for this procedure, patients should be aware that commercial negotiated rates for this service range widely among payers, from $64 to $172. Because these negotiated rates often exceed the cash price, patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, provided they have verified their out-of-pocket maximums and deductible status beforehand.
To ensure you are receiving the most accurate pricing, it is essential to request a prompt-pay discount before scheduling your visit, as hospitals often offer reductions of 20% to 50% for upfront payment. Additionally, if you are using insurance, remember that the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network facilities, though you should still review your itemized bill for any unbundled codes or services not rendered. Always ask the billing department to classify your account as self-pay to secure the lowest possible rate and avoid automatic claims submission that could void any cash discounts.