CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: The Women's Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $25
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 0.11x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at The Women's Hospital is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.11x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$25

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: $39 (17%)
Insurance Median: $25 (11%)
Cash: $39 (17% of Medicare)
Ins. Median: $25 (11% 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
Aetna $7 - $44 3%
Blue Cross Blue Shield $7 - $696 3%
Caresource $7 - $190 3%
Caresource Hip $7 3%
Caresource In $7 3%
Humana $7 - $190 3%
Iu Health $7 - $190 3%
Mdwise Hip $7 3%
Meridian Health Il $7 - $190 3%
Mhs $7 - $190 3%
Mhs Behavioral $7 3%
Molina Il $7 - $190 3%
Molina Ky $7 - $190 3%
Molina Ky Dual $7 - $190 3%
UnitedHealthcare $7 - $190 3%
Wellcare Ky $7 - $190 3%
Ambetter / Centene $8 - $295 4%
Caresource Marketplace (Just4Me) $9 - $285 4%
Encorecombined $9 - $47 4%
Encoreprime $9 - $45 4%
Hst $9 - $285 4%
Immergrun $9 - $28 4%
Patoka Valley Health Care (80/20 Plan) $9 - $41 4%
Patoka Valley Health Care (90/10 Plan) $9 - $40 4%
Alliance Coal $10 - $46 4%
Allied National/Zelis - Freedom Plan $10 - $466 4%
Claimdoc $10 - $276 4%
Chamber Care $11 - $47 5%
Hope Trust $11 - $314 5%
Noncontracted $11 - $304 5%
One Care $11 - $47 5%
Passport Molina Ky $11 - $15 5%
Amish $18 - $76 8%
Self Pay $18 - $39 8%
Cigna $25 - $48 11%
Claritev (Formerly Phcs/Mulitplan) $25 - $46 11%
First Health/Coventry $25 - $49 11%
Healthlink $25 - $56 11%
Sagamore $25 - $48 11%
Center Care $31 - $52 14%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4199 Gateway Blvd, Newburgh, IN 47630
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals