CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Uofl Health - Shelbyville Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $247
  • Cash Discount Price: $157
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Uofl Health - Shelbyville Hospital is $247. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.10x the Medicare baseline. Located in 727 Hospital Drive, Shelbyville, KY.
Cash / Self-Pay
$157

Average discount available for prompt cash payment at this facility.

Insurance Median
$247

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: $157 (70%)
Insurance Median: $247 (110%)
Cash: $157 (70% of Medicare)
Ins. Median: $247 (110% 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
Passport $55 - $254 25%
UnitedHealthcare $66 - $197 30%
Wellcare $66 - $261 30%
Aetna $69 31%
Blue Cross Blue Shield $69 - $313 31%
Humana $69 - $191 31%
Prime Group Health $146 - $350 65%
Senior Care Communty Of Ky $187 84%
Cigna $191 85%
Essence Health $191 85%
Va Ccn $191 85%
Devoted $196 88%
Signature $196 - $206 88%
Communicare $200 89%
Velocity $233 - $404 104%
Encore $247 110%
Key Benefit Administrators $248 111%
Multiplan $272 - $371 122%
Omca $391 175%
Corvel $412 184%
Cshn $412 184%
Health Smart $412 184%
National Comp Care $412 184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 727 Hospital Drive, Shelbyville, KY 40065
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals