CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: St Lukes Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $81
  • Cash Discount Price: $168
  • vs. Medicare Baseline: 0.36x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at St Lukes Regional Medical Center is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.36x the Medicare baseline. Located in 2720 Stone Park Boulevard, Sioux City, IA.
Cash / Self-Pay
$168

Average discount available for prompt cash payment at this facility.

Insurance Median
$81

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: $168 (75%)
Insurance Median: $81 (36%)
Cash: $168 (75% of Medicare)
Ins. Median: $81 (36% 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 - $497 3%
Amerivantage $7 - $208 3%
Blue Cross Blue Shield $7 - $202 3%
Humana $7 - $208 3%
Molina $7 - $202 3%
UnitedHealthcare $7 - $543 3%
Avera Health Plan $10 - $136 4%
Nebraska Total Care $12 - $55 5%
Wellmark Uph Self-Funded $15 7%
Cigna $18 - $132 8%
Health Partners Open Network $32 - $304 14%
Medica Exchange Inspire $108 48%
Medica Exchange Insure $121 54%
Amerigroup $180 80%
Iowa Total Care $180 80%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2720 Stone Park Boulevard, Sioux City, IA 51104
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals