CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Caribou Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $84
  • Cash Discount Price: $60
  • vs. Medicare Baseline: 0.38x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Caribou Medical Center is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $60. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.38x the Medicare baseline. Located in 300 South 3Rd West, Soda Springs, ID.
Cash / Self-Pay
$60

Average discount available for prompt cash payment at this facility.

Insurance Median
$84

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: $60 (27%)
Insurance Median: $84 (38%)
Cash: $60 (27% of Medicare)
Ins. Median: $84 (38% 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
Humana $8 - $252 4%
Pacific Source Mcr Adv $8 - $252 4%
Regence Blue Shield Mcr $8 - $252 4%
Select Health Mcr Adv $8 - $252 4%
Blue Cross Blue Shield $9 - $255 4%
Select Health-All Other Plans $12 - $237 5%
Cigna $13 - $237 6%
Aetna $24 - $237 11%
Bc Qualified Hp (Qhp) $28 - $225 13%
Select Health/Bright Path Mcr Adv $28 - $252 13%
Montana Health Co-Op-All Plans $30 - $237 13%
Regence Blue Shield-All Other Plans $30 - $237 13%
First Choice Health-All Plans $71 - $218 32%
Pacific Source-All Other Plans $76 - $235 34%
UnitedHealthcare $77 - $235 34%
Deseret Healthcare-All Plans $82 - $230 37%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 South 3Rd West, Soda Springs, ID 83276
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals