CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Dupont Hospital LLC

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $41
  • Cash Discount Price: $23
  • vs. Medicare Baseline: 0.18x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Dupont Hospital LLC is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.18x the Medicare baseline. Located in 2520 E Dupont Rd, Fort Wayne, IN.
Cash / Self-Pay
$23

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $23 (10%)
Insurance Median: $41 (18%)
Cash: $23 (10% of Medicare)
Ins. Median: $41 (18% 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%
Physicians Health Plan $11 - $192 5%
Amish Aid $12 - $134 5%
Self Pay $12 - $224 5%
Lutheran Preferred $14 - $463 6%
Cigna $15 - $180 7%
Php Freedom Network $15 - $165 7%
Aetna $17 - $228 8%
Encore Ppo $23 - $248 10%
Lutheran Network $23 - $248 10%
Medical Mutual Of Oh $24 - $263 11%
Blue Cross Blue Shield $25 - $952 11%
Caresource $25 11%
Humana $25 - $228 11%
Managed Health Services $25 - $463 11%
Medicaid / KanCare $25 11%
Sagamore $25 - $277 11%
UnitedHealthcare $25 - $241 11%
Prime Health Services $34 - $417 15%
Frontpath $37 - $398 17%
Advantage Health Solutions $38 - $413 17%
Encore Health Network $38 - $447 17%
Multiplan $40 - $447 18%
Allied Benefit Systems $41 - $447 18%
Tricare $220 98%
Medicare (plans) $228 102%
Node Mhs Mcr Adv $228 102%
Department Of Veterans Affairs $232 104%
Iu Health $232 104%
Node Non Par Hospice Agree $232 104%
Node Va $232 104%
Node Devoted Health Mcr Adv $233 104%
In Dept Of Correction $241 108%
Node Pphp Mcr Adv $243 109%
Us Department Of Labor $290 130%
Lutheran Advanced Network $348 156%
Lutheran Preferred Fixed 2 $348 156%
Align In Work Comp $371 166%
Encore Work Comp In $417 186%
In Work Comp $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: 2520 E Dupont Rd, Fort Wayne, IN 46825
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals