CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Perry County Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $348
  • Cash Discount Price: $394
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Perry County Memorial Hospital is $348. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $394. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.56x the Medicare baseline. Located in 8885 Sr 237, Tell City, IN.
Cash / Self-Pay
$394

Average discount available for prompt cash payment at this facility.

Insurance Median
$348

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: $394 (176%)
Insurance Median: $348 (156%)
Cash: $394 (176% of Medicare)
Ins. Median: $348 (156% 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
Medicaid / KanCare $129 - $563 58%
Veterans Administration $141 - $563 63%
Bc 130 $146 - $450 65%
Group Insurance $146 - $563 65%
Medicare (plans) $146 65%
Workers Compensation $282 126%
Nsa $331 - $348 148%
Guarantor Liable $394 - $563 176%
Pcmh Insurnace $439 - $563 196%
Secondary Insurance $450 201%
UnitedHealthcare $450 201%
Operating Engineers $479 214%
Boilermakers Healthcare $490 219%
Cigna $490 219%
Great West $490 - $563 219%
Sagxxxx $490 219%
Champus $563 252%
Ngs American, Inc $563 252%
Patoka Valley $563 252%
Southwire $563 252%
Tricare $563 252%
Wausau Benefits $563 252%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8885 Sr 237, Tell City, IN 47586
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals