CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Southern Hills Hospital and Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $142
Cash Discount Price: $610
vs. Medicare Baseline: 0.63x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Southern Hills Hospital and Medical Center is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $610. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.63x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

$610

Average discount available for prompt cash payment at this facility.

Insurance Median

$142

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: $610 (273%)

Insurance Median: $142 (63%)

Cash: $610 (273% of Medicare)

Ins. Median: $142 (63% 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
Sierra Hpn	$16	7%
Molina Healthcare	$16 - $17	7%
Community Care Health	$16	7%
Ambetter / Centene	$17 - $134	8%
Caresource	$17	8%
Legacy Provider Network	$34	15%
Corvel	$36 - $39	16%
Olympus Medsave USA	$38 - $477	17%
Aetna	$129 - $130	58%
Select Health	$136 - $147	61%
United	$136 - $139	61%
Prominence Healthfirst	$189 - $191	84%
Cmn Global	$265 - $267	118%
Hometown Health Providers	$315 - $318	141%
Evernorth	$315 - $318	141%
Nv Health & Welfare Trust	$378 - $382	169%
Multiplan	$397 - $464	177%
First Health	$416 - $509	186%
Medcare International	$472 - $477	211%

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 $610.
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 Southern Hills Hospital and 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.