CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Cherokee Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $64
  • Cash Discount Price: $63
  • vs. Medicare Baseline: 0.29x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Cherokee Regional Medical Center is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.29x the Medicare baseline. Located in 300 Sioux Valley Drive, Cherokee, IA.
Cash / Self-Pay
$63

Average discount available for prompt cash payment at this facility.

Insurance Median
$64

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: $63 (28%)
Insurance Median: $64 (29%)
Cash: $63 (28% of Medicare)
Ins. Median: $64 (29% 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
Health Partners $34 - $75 15%
Molina $35 - $75 16%
Admin Concepts $64 - $75 29%
Aetna $64 - $75 29%
American Republic $64 - $75 29%
Apw $64 - $75 29%
Auxiant $64 - $75 29%
Avera $64 - $75 29%
Bankers Life $64 - $75 29%
Blue Cross Blue Shield $64 - $75 29%
Champus $64 - $75 29%
Cigna $64 - $75 29%
Humana $64 - $75 29%
Iowa Total Care $64 - $75 29%
Liability $64 - $75 29%
Meridian $64 - $75 29%
Meritain $64 - $75 29%
Midlands $64 - $75 29%
Mutual Of Omaha $64 - $75 29%
Occunet $64 - $75 29%
Physicians Mutual $64 - $75 29%
Private Healthcare $64 - $75 29%
Sanford $64 - $75 29%
United American $64 - $75 29%
UnitedHealthcare $64 - $75 29%
Wellpoint $64 - $75 29%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Sioux Valley Drive, Cherokee, IA 51012
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals