CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Jefferson County Health Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $82
  • Cash Discount Price: $72
  • vs. Medicare Baseline: 0.37x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Jefferson County Health Center is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.37x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$72

Average discount available for prompt cash payment at this facility.

Insurance Median
$82

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: $72 (32%)
Insurance Median: $82 (37%)
Cash: $72 (32% of Medicare)
Ins. Median: $82 (37% 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
UnitedHealthcare $5 - $202 2%
Amerigroup Mcr Adv $6 - $90 3%
Humana $6 - $90 3%
Iowa Total Care Comm - All Other Plans $6 - $90 3%
Iowa Total Care Mcaid $6 - $94 3%
Iowa Total Care Mcr $6 - $90 3%
Medicaid / KanCare $6 - $96 3%
Molina Mcaid/Chip $6 - $94 3%
Molina Mcr Adv $6 - $90 3%
Tricare $6 - $87 3%
Aetna $7 - $202 3%
Medicare (plans) $7 - $110 3%
Midlands New Product $12 - $184 5%
Coventry Commercial Hmo $13 - $190 6%
Coventry Commercial Ppo - All Other Plans $14 - $202 6%
Midlands Choice-All Other Plans $14 - $202 6%
Molina Marketplace - All Other Plans $15 - $224 7%
Wellmark Hmo $443 198%
Wellmark Indemnity/Ppo - All Other Plans $487 218%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals