Breathing treatment (nebulizer)
Facility: Jewell County Hospital
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $45
- Cash Discount Price: $36
- vs. Medicare Baseline: 0.20x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Rural Carriers - All Plans | $13 - $45 | 6% |
| First Health - All Plans | $14 - $50 | 6% |
| Aetna | $14 - $48 | 6% |
| Meritain - All Plans | $14 - $48 | 6% |
| Cigna | $14 - $50 | 6% |
| UnitedHealthcare | $14 - $50 | 6% |
| Midlands Choice - All Plans | $14 - $50 | 6% |
Consumer Guidance & Cost Commentary
For the CPT code 94640, representing a breathing treatment via nebulizer at Jewell County Hospital in Mankato, KS, the facility's cash median rate is $36.00, which is lower than the state average of $49.00. While the hospital's negotiated rates for commercial payers range from $14.00 to $50.00, these amounts are generally higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find paying the $36.00 cash rate more cost-effective than using insurance, as the negotiated rates often exceed the cash price. It is important to note that while the facility is a Critical Access Hospital with government local ownership, the specific negotiated rates vary by insurer, with some plans paying as low as $13.00 and others up to $50.00.
To minimize costs, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. Additionally, since the Medicare benchmark for this service is $223.72, the commercial negotiated rates represent a significant markup compared to the federal baseline, highlighting the value of comparing rates directly against the Medicare amount rather than the hospital's full chargemaster list. If a patient receives an itemized bill, they should request a detailed breakdown to identify any errors or unbundled charges, as over 80% of hospital bills contain discrepancies that can be resolved through a formal audit.