CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Mercyone Dubuque Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $190
  • Cash Discount Price: $7,646
  • vs. Medicare Baseline: 0.85x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Mercyone Dubuque Medical Center is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,646. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.85x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.
Cash / Self-Pay
$7,646

Average discount available for prompt cash payment at this facility.

Insurance Median
$190

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: $7,646 (3418%)
Insurance Median: $190 (85%)
Cash: $7,646 (3418% of Medicare)
Ins. Median: $190 (85% 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
Iowa Dept Of Public Health $2 - $211 1%
Bcn Domestic $5 2%
Blue Benefit Administrators Of Massachusetts $5 2%
Blue Care Network $5 2%
Blue Cross Blue Shield $5 - $3,107 2%
Blue Distinction Transplant $5 2%
Blue Shield - Ca $5 2%
Blue Shield - Id (Regence) $5 2%
Blue Shield - Ny Highmark Northeastern $5 2%
Blue Shield - Ny Highmark Western $5 2%
Blue Shield - Pa (Highmark) $5 2%
Blue Shield - Wa (Regence) $5 2%
Kaiser Domestic $5 2%
Pre-Employment $5 2%
Wc Domestic $5 2%
Preferred Health Choice $75 34%
Health Choices $77 34%
Midlands Choice $122 - $190 55%
Wps $126 56%
The Alliance $127 57%
Geha $137 61%
UnitedHealthcare $137 - $3,138 61%
Mhnet $169 76%
1199 National Benefit Fund $176 79%
Aetna $176 - $3,076 79%
Allied Benefit Systems $176 79%
Asr Health Benefits $176 79%
Christian Brother Services $176 79%
Coventry $176 79%
First Health $176 79%
Lucent Health $176 79%
Luminare Health $176 79%
Medical Mutual $176 79%
Meritain $176 79%
Trustmark Small Business Benefits $176 79%
Webtpa $176 79%
Auxiant $190 85%
Cigna $190 85%
Medica $190 85%
Midlands $190 85%
Multiplan $190 85%
Unity $190 85%
Iowa Total Care $196 - $2,833 88%
Medicaid / KanCare $198 - $2,872 89%
Crime Victim Assistance $211 94%
Stephenson Cty Health $211 94%
Medicare (plans) $213 - $3,202 95%
Amish Hospital Aid $290 - $4,175 130%
Oscar $297 - $4,282 133%
Centivo $341 - $4,915 152%
Ambetter / Centene $366 - $5,273 164%
Claimdoc $438 - $6,309 196%
Nova $438 - $6,309 196%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Mercy Drive, Dubuque, IA 52001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals