Breathing treatment (nebulizer)
Facility: Northwest Health - Porter
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $358
- Cash Discount Price: $238
- vs. Medicare Baseline: 1.60x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $8 | 4% |
| Blue Cross Blue Shield | $25 - $944 | 11% |
| Caresource | $25 | 11% |
| Humana | $25 - $228 | 11% |
| Managed Health Services | $25 - $463 | 11% |
| Medicaid / KanCare | $25 | 11% |
| Mhs | $25 | 11% |
| UnitedHealthcare | $25 - $260 | 11% |
| Lutheran Preferred Chs Employees | $159 - $784 | 71% |
| Self Pay | $178 - $882 | 80% |
| Cigna | $184 - $908 | 82% |
| Aetna | $220 - $1,578 | 98% |
| Tricare | $220 | 98% |
| Medicare (plans) | $228 - $243 | 102% |
| Node Mhs Mcr Adv | $228 | 102% |
| Healthy Indiana Plan | $232 | 104% |
| Node Hospice Non Par Agree | $232 | 104% |
| Node Va | $232 | 104% |
| Node Devoted Health Mcr Adv | $233 | 104% |
| Care Improvement Plus | $239 | 107% |
| In Dept Of Correction | $241 | 108% |
| Physicians Health Plan | $253 - $1,252 | 113% |
| Php Freedom | $273 - $1,350 | 122% |
| Node Us Dept Of Labor | $290 | 130% |
| Sagamore Health Network | $292 - $1,934 | 131% |
| Lutheran Preferred | $297 - $1,960 | 133% |
| First Health Coventry | $324 - $1,601 | 145% |
| Encore Ppo | $330 - $1,633 | 148% |
| Align Network | $371 | 166% |
| One Call Work Comp | $371 | 166% |
| Encore Health | $417 - $2,614 | 186% |
| Prime Health | $417 - $2,450 | 186% |
| Indiana Work Comp | $463 | 207% |
| Southeastem Indiana Health Operations | $463 - $2,450 | 207% |
| Network Synergy Group | $496 - $2,450 | 222% |
| Multiplan/Phcs | $555 - $2,744 | 248% |
| Node Encore Kba Epo | $556 | 249% |
| Porter County | $556 | 249% |
| Preferred Network Access | $556 | 249% |
| Magnacare Ma | $590 | 264% |