CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Gibson General Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $26
  • Cash Discount Price: $43
  • vs. Medicare Baseline: 0.12x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Gibson General Hospital is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.12x the Medicare baseline. Located in 1808 Sherman Drive, Princeton, IN.
Cash / Self-Pay
$43

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $43 (19%)
Insurance Median: $26 (12%)
Cash: $43 (19% of Medicare)
Ins. Median: $26 (12% 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 - $63 3%
Blue Cross Blue Shield $7 - $1,228 3%
Caresource $7 3%
Caresource Just For Me $7 - $26 3%
Mdwise Plans $7 3%
Medicaid / KanCare $7 3%
Medicare (plans) $7 - $26 3%
Meridiancare (Il) $7 - $26 3%
Meridiancomplete (Il) $7 - $26 3%
Meridianhealth (Il) $7 3%
Mhs $7 3%
Mytruadvantage $7 - $26 3%
UnitedHealthcare $7 - $57 3%
Va Ccn $7 - $26 3%
Ambetter / Centene $9 - $26 4%
Caresource In Marketplace $9 - $45 4%
Encircle/Encore Combined $9 - $69 4%
Encircle/Encore Prime $9 - $61 4%
Alliance Coal $10 - $20 4%
Claimdoc $10 - $69 4%
Deaconess Onecare $11 - $461 5%
Hopetrust $11 - $69 5%
Hstechnology $11 - $69 5%
Noncontracted $11 - $41 5%
Ky Racing Health & Welfare Fund $18 - $44 8%
Self-Pay $18 - $43 8%
Cigna $25 - $71 11%
First Health $25 - $73 11%
Healthlink Hmo $25 - $73 11%
Healthlink Ppo $25 - $73 11%
Sagamore (Ppo, Oap-Open Access Plus, Epo, Choice Fund Oap+) $25 - $71 11%
Chambercare $31 - $65 14%
Gibson County Sheriff $44 - $69 20%
Integrated Health $47 - $73 21%
Principal Health Care $47 - $73 21%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1808 Sherman Drive, Princeton, IN 47670
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals