CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Gadsden Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $200
  • Cash Discount Price: $72
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Gadsden Regional Medical Center is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.89x the Medicare baseline. Located in 1007 Goodyear Avenue, Gadsden, AL.
Cash / Self-Pay
$72

Average discount available for prompt cash payment at this facility.

Insurance Median
$200

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: $72 (32%)
Insurance Median: $200 (89%)
Cash: $72 (32% of Medicare)
Ins. Median: $200 (89% 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.

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
Veterans Eval Services $7 3%
Medicaid / KanCare $18 8%
Self Pay $58 - $87 26%
UnitedHealthcare $96 - $238 43%
Tricare $190 85%
American Employee Alliance $192 86%
Blue Cross Blue Shield $193 86%
Humana $193 86%
Medicare (plans) $193 86%
Node Viva Mcr Adv $193 86%
Node Select Health Mcr Adv $195 87%
Amedisys Hospice $196 88%
Gadsden Hospice $196 88%
Node Non Par Hospice Agree $196 88%
Node Va $196 88%
Southern Care Hospice $196 88%
Cigna $197 - $1,162 88%
Node Devoted Health Mcr Adv $197 88%
Node Clover Health Mcr Adv $198 89%
Aetna $199 - $249 89%
Node Champva $200 89%
Node Wellcare Mcr Adv $200 89%
Node Eon Mcr Adv $203 91%
Prime Health $207 - $348 93%
Node Us Dept Of Labor $246 110%
Multiplan $269 - $303 120%
Magellan Behavioral $289 129%
Viva Healthcare $289 129%
Ambetter / Centene $295 132%
First Health $337 - $389 151%
Beech Street $351 - $1,525 157%
Alamed Wc $361 161%
Focus Health $368 164%
Coventry Work Comp Al $376 168%
Work Comp $409 183%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Goodyear Avenue, Gadsden, AL 35903
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals