CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Hillcrest Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $336
Cash Discount Price: $198
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Hillcrest Medical Center is $336. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.50x the Medicare baseline. Located in 1120 South Utica Avenue, Tulsa, OK.

Cash / Self-Pay

$198

Average discount available for prompt cash payment at this facility.

Insurance Median

$336

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: $198 (89%)

Insurance Median: $336 (150%)

Cash: $198 (89% of Medicare)

Ins. Median: $336 (150% 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
Oscar Insurance Company [7005]	$165	74%
Hooray Health [8000]	$165	74%
Lucent Health [6000]	$165	74%
Osma Health Network [2345]	$165	74%
Black Lung [6055]	$165	74%
Healthcare Highways [2210]	$165 - $255	74%
Oncology Patient Assistance Programs [2295]	$165	74%
UnitedHealthcare	$210	94%
Healthscope Benefits [2290]	$210	94%
Resource One Administrators [2815]	$255	114%
Web Tpa [2115]	$255 - $290	114%
Meritain Health [1655]	$290	130%
Aetna	$290	130%
The Kempton Group Administrators [2905]	$297	133%
Multiplan [1680]	$375 - $568	168%
Medica [2910]	$375	168%
Employee Benefit Management Services [2445]	$482	215%
PHCS [1780]	$482 - $568	215%
Mayo Clinic Health Solutions [2280]	$568	254%
Allied National Global Care [1035]	$568	254%
Administrative Concepts [1005]	$568	254%
Healthfirst [2395]	$568	254%
Allied Benefit Systems Inc [1030]	$568	254%
Universal Fidelity [2085]	$568	254%
Hometown Health [2155]	$568	254%
Healthcost Solutions [2415]	$568	254%
Planned Administrators Inc [2360]	$568	254%
New Era Life Insurance Company [1705]	$568	254%
Pan American Life Insurance Co [1770]	$568	254%
Trustmark [2030]	$568	254%
Mutual of Omaha [1685]	$568	254%
Pending Ssi [1616]	$660	295%

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 $198.
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 Hillcrest 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.