CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Buena Vista Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $97
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 0.43x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Buena Vista Regional Medical Center is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.43x the Medicare baseline. Located in 1525 West 5Th Street, Storm Lake, IA.
Cash / Self-Pay
$95

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $95 (42%)
Insurance Median: $97 (43%)
Cash: $95 (42% of Medicare)
Ins. Median: $97 (43% 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 $53 - $138 24%
Ambetter / Centene $53 - $138 24%
Blue Cross Blue Shield $53 - $138 24%
Champus $53 - $73 24%
Champva $53 - $73 24%
Health Partners $53 - $138 24%
Humana $53 - $138 24%
Iowa Health Advantage $53 - $138 24%
Medicare (plans) $53 - $138 24%
UnitedHealthcare $53 - $138 24%
Wellcare $53 - $138 24%
Wellpoint $53 - $138 24%
American Postal Workers $80 - $110 36%
Avera $85 - $117 38%
Cigna $90 - $124 40%
First Administrators $97 - $134 43%
Golden Rule $97 - $134 43%
Great West $97 - $134 43%
Healthscope $97 - $134 43%
Medical Associates $97 - $134 43%
Meritain $97 - $134 43%
Midlands Choice $97 - $134 43%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1525 West 5Th Street, Storm Lake, IA 50588
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals