CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: St Mary's Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $332
  • Cash Discount Price: $187
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at St Mary's Hospital is $332. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.48x the Medicare baseline. Located in 701 Lewiston St, Cottonwood, ID.
Cash / Self-Pay
$187

Average discount available for prompt cash payment at this facility.

Insurance Median
$332

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: $187 (84%)
Insurance Median: $332 (148%)
Cash: $187 (84% of Medicare)
Ins. Median: $332 (148% 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 $6 - $455 3%
Corizon Correctional - All Plans $8 - $445 4%
Nimiipuu Mcr Adv - Allplans $8 - $384 4%
Regence Blue Shield Mcr $8 - $380 4%
Tricare $8 - $380 4%
UnitedHealthcare $8 - $380 4%
Veterans Admin - All Plans $8 - $380 4%
Medicare (plans) $9 - $380 4%
Aetna $13 - $432 6%
Idaho Phys Network - All Plans $32 - $441 14%
First Choice- All Plans $33 - $455 15%
Geha - All Plans $33 - $450 15%
Multiplan - All Plans $33 - $450 15%
Regence Blue Shield - All Other Plans $464 207%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Lewiston St, Cottonwood, ID 83522
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals