CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Rush Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $240
  • Cash Discount Price: $257
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Rush Memorial Hospital is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $257. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.07x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.
Cash / Self-Pay
$257

Average discount available for prompt cash payment at this facility.

Insurance Median
$240

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: $257 (115%)
Insurance Median: $240 (107%)
Cash: $257 (115% of Medicare)
Ins. Median: $240 (107% 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
Humana $7 - $2,426 3%
UnitedHealthcare $7 - $2,110 3%
Aetna $8 - $2,426 4%
Blue Cross Blue Shield $8 - $1,932 4%
Caresource Mcr Adv $8 - $818 4%
Consumers Life Ins-All Plans $8 - $2,374 4%
Encore Health Services-All Plans $8 - $2,585 4%
My True Advantage - All Plans $8 - $818 4%
Siho-All Plans $8 - $2,426 4%
Today'S Option Mcr Adv-All Plans $8 - $842 4%
Viant Beech St Mcr Adv $8 - $842 4%
Multiplan-All Plans $9 - $2,453 4%
Caresource Marketplace-All Other Plans $11 - $1,308 5%
Phcs-All Plans $23 - $2,110 10%
Cigna $37 - $2,110 17%
Health Net $37 - $777 17%
Coventry/First Health-All Plans $51 - $2,374 23%
Sagamore-All Plans $305 - $2,426 136%
Community Health Alliance-All Plans $312 - $2,479 139%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1300 N Main St, Rushville, IN 46173
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals