CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Decatur County Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $56
Cash Discount Price: $77
vs. Medicare Baseline: 0.25x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Decatur County Memorial Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.25x the Medicare baseline. Located in 720 North Lincoln Street, Greensburg, IN.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

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: $77 (34%)

Insurance Median: $56 (25%)

Cash: $77 (34% of Medicare)

Ins. Median: $56 (25% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$5 - $134	2%
Blue Cross Blue Shield	$5 - $176	2%
Caresource Mcr Adv	$5 - $54	2%
Choice Care Mcr Adv	$5 - $51	2%
Siho Mcr Adv	$5 - $51	2%
UnitedHealthcare	$5 - $155	2%
Caresource Just4Me-All Other Plans	$8 - $87	4%
Cigna	$12 - $136	5%
Sagamore Health-All Plans	$13 - $141	6%
Encircle-All Plans	$14 - $150	6%
Healthsource Indiana-All Plans	$14 - $158	6%
Choicecare Commercial-All Other Plans	$15 - $164	7%
Thcg/Encore-All Plans	$15 - $165	7%
Medicaid / KanCare	$16 - $176	7%
Siho-All Other Plans	$16 - $171	7%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $77.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Decatur County Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.