CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Henry County Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $230
  • Cash Discount Price: $208
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Henry County Memorial Hospital is $230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $208. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.03x the Medicare baseline. Located in 1000 N 16Th St, New Castle, IN.
Cash / Self-Pay
$208

Average discount available for prompt cash payment at this facility.

Insurance Median
$230

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: $208 (93%)
Insurance Median: $230 (103%)
Cash: $208 (93% of Medicare)
Ins. Median: $230 (103% 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 $7 - $302 3%
Caresource Mcaid $7 - $311 3%
Humana $7 - $266 3%
UnitedHealthcare $7 - $246 3%
Aetna $8 - $257 4%
Caresource Hip $8 - $235 4%
Caresource Mcr Adv $8 - $240 4%
Encore Workers Comp-All Plans $8 - $287 4%
Caresource Marketplace-All Other Plans $11 - $446 5%
Caresource Just4Me $12 - $587 5%
Cigna $20 - $206 9%
Health Alliance-All Plans $34 - $257 15%
Workers Comp - All Plans $36 - $272 16%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 N 16Th St, New Castle, IN 47362
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals