CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Sartori Memorial Hospital, Inc

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $222
  • Cash Discount Price: $176
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Sartori Memorial Hospital, Inc is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.99x the Medicare baseline. Located in 515 College Street, Cedar Falls, IA.
Cash / Self-Pay
$176

Average discount available for prompt cash payment at this facility.

Insurance Median
$222

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: $176 (79%)
Insurance Median: $222 (99%)
Cash: $176 (79% of Medicare)
Ins. Median: $222 (99% 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 $42 - $206 19%
Allied Benefit Systems $42 19%
Asr Health Benefits $42 19%
Coventry $42 19%
First Health $42 19%
Lucent Health $42 19%
Luminare Health $42 19%
Medical Mutual $42 19%
Meritain $42 19%
Webtpa $42 19%
Health Choices $63 28%
Medical Associates $63 28%
Health Partners $88 39%
Auxiant $192 86%
Cigna $192 86%
Medica $192 86%
Midlands $192 86%
Midlands Choice $192 86%
Medicare (plans) $206 - $215 92%
Blue Cross Blue Shield $208 - $224 93%
UnitedHealthcare $210 - $270 94%
Iowa Total Care $220 98%
Medicaid / KanCare $222 - $223 99%
Bcn Domestic $224 100%
Blue Benefit Administrators Of Massachusetts $224 100%
Blue Care Network $224 100%
Blue Distinction Transplant $224 100%
Blue Shield - Ca $224 100%
Blue Shield - Id (Regence) $224 100%
Blue Shield - Ny Highmark Northeastern $224 100%
Blue Shield - Ny Highmark Western $224 100%
Blue Shield - Pa (Highmark) $224 100%
Blue Shield - Wa (Regence) $224 100%
Kaiser Domestic $224 100%
Pre-Employment $224 100%
Wc Domestic $224 100%
Geha $265 118%
Iowa Dept Of Public Health $270 121%
Amish Hospital Aid $280 125%
Oscar $323 144%
Centivo $349 156%
Ambetter / Centene $354 158%
Claimdoc $423 189%
Nova $423 189%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 515 College Street, Cedar Falls, IA 50613
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals