CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Kosciusko Community Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $42
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 0.19x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Kosciusko Community Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.19x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $20 (9%)
Insurance Median: $42 (19%)
Cash: $20 (9% of Medicare)
Ins. Median: $42 (19% 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 Wc $8 4%
Amish Aid $10 - $170 4%
Self Pay $10 - $316 4%
Lutheran Preferred Network $15 - $647 7%
Physicians Health Plan $17 - $373 8%
Encore $18 - $324 8%
Php Freedom Network $18 - $312 8%
Trma Inc $18 - $364 8%
UnitedHealthcare $18 - $426 8%
Aetna $19 - $430 8%
Caresource $19 - $25 8%
Blue Cross Blue Shield $25 - $952 11%
Humana $25 - $244 11%
Managed Health Services $25 11%
Medicaid / KanCare $25 11%
Mhs $25 - $244 11%
Connecticut General Life Insurance Company $27 - $476 12%
Cigna $29 - $511 13%
First Health Network $34 - $607 15%
Prime Health Services $34 - $607 15%
Advantage Health $38 - $671 17%
Private Healthcare Systems $40 - $696 18%
Sagamore $40 - $760 18%
Encore Health Network $43 - $752 19%
Tricare $220 98%
Department Of Veterans Affairs $232 104%
Medicare (plans) $244 109%
Iu Health $248 111%
Node Non Par Hospice Agree $248 111%
Node Va $248 111%
Node Devoted Health Mcr Adv $249 111%
In Dept Of Correction $258 115%
Node Pphp Mcr Adv $261 117%
Us Department Of Labor $310 139%
Lutheran Advanced Network $372 166%
Lutheran Preferred $372 - $496 166%
Align In Work Comp $397 177%
One Call Work Comp $397 177%
Encore Work Comp In $447 200%
Managed Health Services Exchange $496 222%
Workers Comp $496 222%
Encore Kba Epo $596 266%
Encore Kba Ppo $744 333%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals