CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $167
  • Cash Discount Price: $156
  • vs. Medicare Baseline: 0.75x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at University of Iowa Health Care Medical Center Down is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.75x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.
Cash / Self-Pay
$156

Average discount available for prompt cash payment at this facility.

Insurance Median
$167

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: $156 (70%)
Insurance Median: $167 (75%)
Cash: $156 (70% of Medicare)
Ins. Median: $167 (75% 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
Aetna $7 - $216 3%
Blue Cross Blue Shield $7 - $193 3%
Healthpartners $7 - $307 3%
Iowa Total Care $7 - $199 3%
Medical Associates $7 - $242 3%
Molina Healthcare $7 - $144 3%
UnitedHealthcare $7 - $274 3%
Wellpoint (Amerigroup) $7 - $201 3%
Aplos Health Plan $16 - $289 7%
Immergrun $18 - $90 8%
Midlands Choice $35 - $235 16%
Oscar Health $45 - $227 20%
Quad City Community Healthcare $47 - $271 21%
Great River Health Systems $50 - $253 22%
Sedgwick $58 - $289 26%
Global Excel $61 - $307 27%
Sanford Health Plan $61 - $307 27%
Employee Benefit Systems $63 - $325 28%
Sisco $63 - $318 28%
Healthsmart $65 - $325 29%
Hfn $66 - $332 30%
Multiplan $66 - $332 30%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 E Market Street, Iowa City, IA 52245
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals