CMS Price Transparency Data
Breathing treatment (nebulizer)
Facility: Claiborne Memorial Medical Center
Billing Code: 94640 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 94640
- Insurance Median: $150
- Cash Discount Price: $150
- vs. Medicare Baseline: 0.67x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Claiborne Memorial Medical Center is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.67x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$150
Average discount available for prompt cash payment at this facility.
Insurance Median
$150
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: $150 (67%)
Insurance Median: $150 (67%)
Cash: $150 (67% of Medicare)
Ins. Median: $150 (67% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ambetter / Centene | $6 | 3% |
| Medicaid / KanCare | $6 - $237 | 3% |
| Aetna | $9 - $359 | 4% |
| Commercial Insurance | $9 - $552 | 4% |
| Meritain Health | $9 - $359 | 4% |
| Amerihealth Caritas La | $10 - $237 | 4% |
| Community Health Solution | $10 - $237 | 4% |
| Correctcare Intergrated | $10 - $237 | 4% |
| Healthy Blue | $10 - $237 | 4% |
| Humana | $10 - $552 | 4% |
| Louisiana Hc Connections | $10 - $237 | 4% |
| Magellan Services | $10 - $237 | 4% |
| UnitedHealthcare | $10 - $237 | 4% |
| Coventry Healthcare | $14 - $331 | 6% |
| Geha | $16 - $386 | 7% |
| Health Plus Of La | $16 - $414 | 7% |
| Apwu Healthplan | $17 - $414 | 8% |
| Cigna | $17 - $414 | 8% |
| Great West Healthcare | $17 - $414 | 8% |
| Phcs | $18 - $442 | 8% |
| Ppo Plus | $18 - $442 | 8% |
| Sedgwick Claims Mgmt Serv | $21 - $497 | 9% |
| Workman'S Comp | $21 - $497 | 9% |
| Aarp | $23 - $552 | 10% |
| Accordia National | $23 - $552 | 10% |
| Aflac | $23 - $552 | 10% |
| Alameda Alliance Forhealt | $23 - $552 | 10% |
| American Pioneer | $23 - $552 | 10% |
| Benefit Management | $23 - $552 | 10% |
| Benesys Inc | $23 - $552 | 10% |
| Business Guarantor | $23 - $552 | 10% |
| Chubb | $23 - $552 | 10% |
| Commercial Sr. Care | $23 - $552 | 10% |
| Employee Benefit Services | $23 - $552 | 10% |
| Family Life Insurance Co | $23 - $552 | 10% |
| Farm Bureau Insurance | $23 - $552 | 10% |
| Fiserv Health Benefit | $23 - $552 | 10% |
| Gmp | $23 - $552 | 10% |
| Group And Pension Admin | $23 - $552 | 10% |
| Group Resources | $23 - $552 | 10% |
| Haik Minvielle And Grubbs | $23 - $552 | 10% |
| Harrington Benefit Svs | $23 - $552 | 10% |
| Health Design Plus | $23 - $552 | 10% |
| Health Plan | $23 - $552 | 10% |
| Healthscope Benefits | $23 - $552 | 10% |
| Insurance Management Admi | $23 - $552 | 10% |
| Jefferson National | $23 - $552 | 10% |
| John Alden Health Ins | $23 - $552 | 10% |
| John Hancock | $23 - $552 | 10% |
| Liberty Mutual | $23 - $552 | 10% |
| Mailhandlers Benefit Plan | $23 - $552 | 10% |
| Manhattan Life Ins Co | $23 - $552 | 10% |
| Mega Life And Health | $23 - $552 | 10% |
| Msa Careguard | $23 - $552 | 10% |
| Mutual Of Omaha | $23 - $552 | 10% |
| Nalc Health Benefit Plan | $23 - $552 | 10% |
| Naphcare Inc. | $23 - $552 | 10% |
| New Era Life Ins Co | $23 - $552 | 10% |
| Physicians Mutual | $23 - $552 | 10% |
| Principal Financial Group | $23 - $552 | 10% |
| Prudential Healthcare | $23 - $552 | 10% |
| Self Pay | $23 - $552 | 10% |
| State Farm | $23 - $552 | 10% |
| State Farm Insurance | $23 - $552 | 10% |
| State Mutual Insurance Co | $23 - $552 | 10% |
| Sterling Investors Life | $23 - $552 | 10% |
| Tower Life | $23 - $552 | 10% |
| Transamerica Premier Ins | $23 - $552 | 10% |
| United American | $23 - $552 | 10% |
| United Comm Travelers | $23 - $552 | 10% |
| United Teachers | $23 - $552 | 10% |
| Usable Administrator | $23 - $552 | 10% |
| Visn 16 Cfu | $23 - $552 | 10% |
| Wausau Benefits | $23 - $552 | 10% |
| Webtpa | $23 - $552 | 10% |
| Wells Fargo | $23 - $552 | 10% |
| Woodmen Of The World | $23 - $552 | 10% |
| Blue Cross Blue Shield | $81 | 36% |