CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Southeast Iowa Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $41
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.18x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Southeast Iowa Regional Medical Center is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.18x the Medicare baseline. Located in 1221 South Gear Avenue, West Burlington, IA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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%)
Insurance Median: $41 (18%)
Ins. Median: $41 (18% 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
American Healthplan Of Iowa - Midlevel $6 3%
Humana $8 4%
American Healthplan Of Iowa - Md $9 4%
Blue Cross Blue Shield $15 - $204 7%
Medicaid / KanCare $15 - $17 7%
Aetna $17 8%
Elap $17 - $24 8%
UnitedHealthcare $20 9%
Plain Church $28 - $298 13%
Midlands Choice $32 - $413 14%
Absolute Solutions $39 - $302 17%
First Agency $39 - $302 17%
Multiplan $39 - $302 17%
Henderson County $41 - $319 18%
Immergrun $141 63%
6 Degree $179 - $367 80%
Wellpoint (Amerigroup) $257 115%
Immugrun $289 129%
Brighton Amish Church $298 133%
Geha $427 191%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1221 South Gear Avenue, West Burlington, IA 52655
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals