CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Iowa Specialty Hospital - Belmond

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $123
Cash Discount Price: $206
vs. Medicare Baseline: 0.55x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Iowa Specialty Hospital - Belmond is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $206. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.55x the Medicare baseline. Located in 403 First Street Se, Belmond, IA.

Cash / Self-Pay

$206

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $206 (92%)

Insurance Median: $123 (55%)

Cash: $206 (92% of Medicare)

Ins. Median: $123 (55% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$8 - $585	4%
Tricare	$8 - $197	4%
Triwest Va Choice And Pc3-All Plans	$8 - $197	4%
UnitedHealthcare	$8 - $539	4%
Healthscope Stellar - All Plans	$13 - $325	6%
Wellmark Hmo	$31 - $195	14%
Health Partners Ish-All Other Plans	$32 - $493	14%
Cigna	$36 - $598	16%
Midlands Choice-All Plans	$36 - $598	16%
Wellmark Ppo-All Other Plans	$38 - $214	17%
Auxiant Clarion Schools-All Plans	$45 - $400	20%
Health Partners Prestage	$52 - $462	23%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $206.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Iowa Specialty Hospital - Belmond is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.