CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Mercy Hospital Fort Smith
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $130
- Cash Discount Price: $106
- vs. Medicare Baseline: 0.58x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Mercy Hospital Fort Smith is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.58x the Medicare baseline. Located in 7301 Rogers Ave, Fort Smith, AR.
Cash / Self-Pay
$106
Average discount available for prompt cash payment at this facility.
Insurance Median
$130
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: $106 (47%)
Insurance Median: $130 (58%)
Cash: $106 (47% of Medicare)
Ins. Median: $130 (58% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Arkansas Department Of Health [20036] | $6 | 3% |
| Medicaid / KanCare | $6 - $265 | 3% |
| Summit Community Care Contracted [320368] | $6 | 3% |
| Summit Community Care [20368] | $6 | 3% |
| Aetna | $7 - $186 | 3% |
| Humana | $7 - $186 | 3% |
| Arkansas Total Care Contracted [320039] | $14 | 6% |
| Arkansas Total Care [20039] | $14 | 6% |
| Mercy Interfacility [20513] | $36 | 16% |
| Aither Health Contracted [320449] | $41 | 18% |
| Edison Health Solutions Contracted [320502] | $41 | 18% |
| Mercy Benefit Admin Contracted [320251] | $41 - $98 | 18% |
| Qual Choice Contracted [320324] | $50 | 22% |
| United Medical Resources Contracted [320454] | $78 - $147 | 35% |
| UnitedHealthcare | $78 - $190 | 35% |
| 90 Degree Benefits Contracted [320436] | $82 | 37% |
| Show-Me Health Administrators Contracted [320483] | $82 | 37% |
| Cigna | $93 - $195 | 42% |
| Auxiant Contracted [320462] | $98 - $106 | 44% |
| Ebms Contracted [320493] | $98 | 44% |
| Healthlink Contracted [320179] | $98 - $106 | 44% |
| Imagine 360 Contracted [320494] | $98 | 44% |
| Municipal Health Plan Contracted [320271] | $98 | 44% |
| Reflect Health Contracted [320492] | $98 | 44% |
| Insurance System Inc Contracted [320465] | $106 | 47% |
| Personify Health Contracted [320051] | $106 | 47% |
| Preferred Health Plan Contracted [320522] | $106 | 47% |
| Workers Comp [20426] | $106 | 47% |
| Novasys Contracted [320285] | $114 - $265 | 51% |
| Ppo Plus Contracted [320310] | $122 | 55% |
| First Health Contracted [320128] | $126 | 56% |
| Employers Health Coalition Contracted [320116] | $128 | 57% |
| Private Health Care Systems Contracted [320320] | $130 | 58% |
| Private Health Care Systems [20320] | $130 | 58% |
| Multiplan Contracted [320270] | $139 | 62% |
| Multiplan [20270] | $139 | 62% |
| Blue Cross Blue Shield | $182 - $204 | 81% |
| American Health Advantage Of Mo Mcr [20264] | $186 | 83% |
| Cherokee Nation Health Serv Contracted [320066] | $186 | 83% |
| Cross Timbers Hospice [20098] | $186 | 83% |
| Dept Of Veteran Affairs Contracted [320106] | $186 | 83% |
| Elara Caring Aspire Hospice Contracted [320433] | $186 | 83% |
| Elara Caring Aspire Hospice [20433] | $186 | 83% |
| Globalhealth Contracted [320145] | $186 | 83% |
| Halo Hcr Inc Hospice Contracted [320432] | $186 | 83% |
| Halo Hcr Inc Hospice [20432] | $186 | 83% |
| Independent Health [20197] | $186 | 83% |
| Jordan Valley Senior Care Pace [20515] | $186 | 83% |
| Kindful Hospice Contracted [320434] | $186 | 83% |
| Kindful Hospice [20434] | $186 | 83% |
| Medical Associates Health [20444] | $186 | 83% |
| Medicare (plans) | $186 - $195 | 83% |
| Mercy Hospice Okc [20252] | $186 | 83% |
| Pace Of The Ozarks [20518] | $186 | 83% |
| Provider Partners Health Plans Contracted [320450] | $186 | 83% |
| Qual Choice Contracted [320325] | $186 | 83% |
| Spina Bifida Hlthcare Benefit [20506] | $186 | 83% |
| Tribute Health Plan Mcr [20338] | $186 | 83% |
| Tricare | $186 | 83% |
| Valir Pace [20503] | $186 | 83% |
| Wellfirst Health Mcr [20443] | $186 | 83% |
| Usable Contracted [320409] | $204 | 91% |
| Ambetter / Centene | $265 | 118% |
| Home State Health Plan Contracted [320187] | $265 | 118% |
| Health Choice Contracted [320166] | $356 | 159% |