CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Bluffton Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $44
  • Cash Discount Price: $28
  • vs. Medicare Baseline: 0.20x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Bluffton Regional Medical Center is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.20x the Medicare baseline. Located in 303 S Main St, Bluffton, IN.
Cash / Self-Pay
$28

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $28 (13%)
Insurance Median: $44 (20%)
Cash: $28 (13% of Medicare)
Ins. Median: $44 (20% 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%
Amish Aid $11 - $88 5%
Physicians Health Plan $11 - $89 5%
Self Pay $11 - $201 5%
Lutheran Preferred Network $14 - $348 6%
Php Freedom Network $14 - $115 6%
Cigna $15 - $130 7%
Php $15 - $117 7%
Aetna $17 - $228 8%
Lutheran Trma $18 - $165 8%
Php Management Systems $18 - $142 8%
Encore Ppo $22 - $179 10%
UnitedHealthcare $22 - $232 10%
Sagamore Sebt $24 - $187 11%
Blue Cross Blue Shield $25 - $952 11%
Caresource $25 11%
Humana $25 - $232 11%
Medicaid / KanCare $25 11%
Mhs $25 11%
Mhs In Hip $25 11%
Sagamore Health Newtork Inc $25 - $196 11%
Consumer Life $29 - $227 13%
Ahg Dana Employees $30 - $238 13%
Align Networks $32 - $256 14%
Prime Health Services $34 - $417 15%
Private Healthcare Systems Inc $34 - $274 15%
Multiplan $37 - $293 17%
Advantage 360 $38 - $304 17%
Encore Health Network $38 - $329 17%
Community Health Alliance $39 - $311 17%
First Health $40 - $315 18%
Allied Benefit Systems $41 - $329 18%
Cardinal Health Alliance $41 - $329 18%
Ppom $41 - $329 18%
Tricare $220 98%
Medicare (plans) $228 102%
Node Iu Health Mcr Adv $228 102%
Node Mhs Mcr Adv $228 102%
Department Of Veterans Affairs $232 104%
Node Non Par Hospice Agree $232 104%
Node Va $232 104%
Northeast Hospice $232 104%
Node Caresource Mcr Adv $233 104%
Node Devoted Health Mcr Adv $233 104%
County Jail Health Care $241 108%
In Dept Of Correction $241 108%
Node Pphp Mcr Adv $243 109%
Us Department Of Labor $290 130%
Lutheran Advanced Network $348 156%
Lutheran Three Rivers Preferred Plus 150 $348 156%
Lutheran Three Rivers Preferred Plus 175 $405 181%
Encore Work Comp In $417 186%
Lutheran Northwest Health Preferred $463 207%
Managed Health Services Exchange $463 207%
Workers Compensation $463 207%
Encore Kba Epo $556 249%
Encore Kba Ppo $695 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals