CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Lutheran Hospital of Indiana

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $38
  • Cash Discount Price: $21
  • vs. Medicare Baseline: 0.17x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Lutheran Hospital of Indiana is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.17x the Medicare baseline. Located in 7950 W Jefferson Blvd, Fort Wayne, IN.
Cash / Self-Pay
$21

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $21 (9%)
Insurance Median: $38 (17%)
Cash: $21 (9% of Medicare)
Ins. Median: $38 (17% 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
Veterans Eval Services $7 3%
One Call Care Diagnostics $8 4%
Physicians Health Plan Of Northern Indiana $11 - $173 5%
Ky Work Comp $12 - $110 5%
Amish Aid $14 - $131 6%
Lutheran Preferred Network $14 - $263 6%
Self Pay $14 - $158 6%
Cigna $15 - $159 7%
Php Freedom Network $15 - $145 7%
Blue Cross Blue Shield $17 - $952 8%
Aetna $18 - $228 8%
Lutheran Preferred $18 - $175 8%
Sagamore $21 - $237 9%
Encore Ppo $22 - $214 10%
Lutheran Network $23 - $463 10%
Care Source $25 11%
Humana $25 - $228 11%
Managed Health Services $25 - $463 11%
Medicaid / KanCare $25 11%
UnitedHealthcare $25 - $232 11%
Multiplan $34 - $364 15%
Prime Health Services $34 - $417 15%
Advantage Health Solutions $38 - $364 17%
Encore Health Network $38 - $394 17%
Allied Benefit Systems $41 - $394 18%
Evolutions $41 - $394 18%
Tricare $220 98%
Iu Health Plan $228 102%
Medicare (plans) $228 102%
Department Of Veterans Affairs $232 104%
Node Hospice Non Par Agree $232 104%
Node Va $232 104%
Node Devoted Health Mcr Adv $233 104%
In Dept Of Correction $241 108%
Node Pphp Mcr Adv $243 109%
Us Department Of Labor $290 130%
Lutheran Advanced Network $348 156%
Node Lutheran Network $348 - $405 156%
Node Lutheran Preferred Fixed 2 $348 156%
Align Network $371 166%
Encore Work Comp In $417 186%
Node Encore Kba Epo $556 249%
Node Encore Kba Ppo $695 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7950 W Jefferson Blvd, Fort Wayne, IN 46804
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals