CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Decatur County Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $112
  • Cash Discount Price: $106
  • vs. Medicare Baseline: 0.50x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Decatur County Hospital is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.50x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$106

Average discount available for prompt cash payment at this facility.

Insurance Median
$112

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: $106 (47%)
Insurance Median: $112 (50%)
Cash: $106 (47% of Medicare)
Ins. Median: $112 (50% 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
Blue Cross Blue Shield $42 19%
Champva -All Plans $59 26%
Everystep Hospice-All Plans $69 31%
Aetna $71 - $104 32%
Tricare $71 32%
UnitedHealthcare $79 - $112 35%
Benefit Admin System-All Plans $86 38%
Humana $96 43%
Meritain Health-All Plans $96 43%
Misc Commercial-All Plans $96 43%
All Savers-All Plans $99 44%
Allied Benefit System-All Plans $99 44%
American Family Ins Grp-All Plans $99 44%
Rural Carrier Benefit Plan-All Plans $102 46%
Christian Healthcare -All Plans $106 47%
Medica-All Other Plans $106 47%
Golden Rule-All Plans $112 50%
Ntca The Rural Broadband-All Plans $112 50%
Cigna $114 51%
Medical Mutual-All Plans $116 52%
Farm Bureau Financial-All Other Plans $119 53%
Farm Bureau Property And Ca $119 53%
Medi Share-All Plans $120 54%
Uhss-All Plans $120 54%
Health Partners-All Plans $121 54%
Lewermark-All Plans $125 56%
Mail Handlers Benefit-All Plans $129 58%
Midlands Choice-All Plans $129 58%
Priority Health-All Plans $132 59%
Iowa Total Care Mcaid-All Plans $135 60%
Amerigroup Mcaid-All Plans $139 62%
Wellmark Hmo $328 147%
Wellmark Ppo - All Other Plans $361 161%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals