CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Mercy Health Lakeshore Campus

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $11
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 0.05x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Mercy Health Lakeshore Campus is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.05x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $74 (33%)
Insurance Median: $11 (5%)
Cash: $74 (33% of Medicare)
Ins. Median: $11 (5% 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 $5 - $168 2%
Aetna $6 - $91 3%
Albany County Correctional Facility $6 3%
Ambetter / Centene $6 3%
Amish Mennonite $6 3%
Ascension St. Vincent Public Safety Medical $6 3%
Bccp $6 3%
Blue Cross Blue Shield $6 - $165 3%
Bmc Healthnet $6 3%
Breast Grant-Connecticut $6 3%
Broward County Dept Of Health $6 3%
California Health And Wellness $6 3%
Can Community Health Inc $6 3%
Cardinal Innovations Lme $6 3%
Care Connections Of Northern Iowa $6 3%
Care Oregon Ohp $6 3%
Cencal Health Plan $6 3%
Cenpatico $6 3%
Champva $6 - $7 3%
Chhuny $6 3%
Childrens Comm Health Plan $6 3%
Childrens Medical Services Title 19 $6 3%
Cigna $6 - $99 3%
City Of Philadelphia $6 3%
Cmh Allegan County $6 3%
Cmh Ausable Valley $6 3%
Cmh Barry County $6 3%
Cmh Bay-Arenac County $6 3%
Cmh Berrien County $6 3%
Cmh Cass County $6 3%
Cmh Central Mi County $6 3%
Cmh Clinton-Eaton-Ingham County $6 3%
Cmh Detroit Wayne Integrated Health Network $6 3%
Cmh Genesee County $6 3%
Cmh Ionia County $6 3%
Cmh Jackson County/Lifeways $6 3%
Cmh Kalamazoo $6 3%
Cmh Kent County $6 3%
Cmh Lenawee County $6 3%
Cmh Livingston County $6 3%
Cmh Macomb $6 3%
Cmh Misc $6 3%
Cmh Monroe County $6 3%
Cmh Montcalm County $6 3%
Cmh Muskegon County $6 3%
Cmh Newaygo County $6 3%
Cmh North Country $6 3%
Cmh Northern Lakes County $6 3%
Cmh Oakland County $6 3%
Cmh Ottawa County $6 3%
Cmh Van Buren County $6 3%
Cmh Washtenaw County $6 3%
Cmh Wayne County/Carelink $6 3%
Cmh Wayne Cty/Com Liv Svcs $6 3%
Cmh West Mi County $6 3%
Community Benefit Health $6 3%
Community Care Behavorial Health $6 3%
Community Care Partners $6 3%
Community Health Choice $6 3%
Connections Csp $6 3%
County Coroner $6 3%
County Funding Generic $6 3%
Covid19 Hrsa Uninsured Testing And Treatment Fund $6 3%
Dean Wi Badgercare $6 3%
Delaware County Department Of Health $6 3%
Delaware First Health $6 3%
Delta Dental Nj $6 3%
Dph Tb Program $6 3%
Dscc $6 3%
Eastpointe Lme $6 3%
Family Health Network $6 3%
Freedom First Healthcare $6 3%
Fresno County Ccs $6 3%
Ghc Scw Wi Badgercare $6 3%
Harbor Health $6 3%
Health Safety Net $6 3%
Healthy Blue Ne $6 3%
Hennepin Health $6 3%
Humana $6 - $102 3%
Id County Ada $6 3%
Id County Canyon $6 3%
Id County Cat Fund $6 3%
Id County Other $6 3%
Id County Payette $6 3%
Idaho Dept Health And Wellfare $6 3%
Idaho Womens Health Check $6 3%
Indiana Breast Cervical Cancer $6 3%
Inland Empire Health Plan $6 3%
Intercommunity Health Ohp $6 3%
Iowa Total Care $6 3%
Jai Medical System $6 3%
Kern Family Health Plan $6 3%
Keystone First $6 3%
Keystone First Chip $6 3%
La Care Health Plan $6 3%
Lakeland Care Inc $6 3%
Managed Health Services - Indiana $6 3%
Maryland Breast & Cervical Program $6 3%
Maryland Healthy Smiles - Scion Dental $6 3%
Maryland Physicians Care $6 3%
Massachusetts Behavioral Health Partnership $6 3%
Mdwise $6 3%
Medi-Cal $6 3%
Medi-Cal Healthnet $6 3%
Medstar Dc Healthy Family $6 3%
Medstar Md Health Choice $6 3%
Mo Home State Health Plan $6 3%
Molina Centennial Care $6 3%
Nascentia Health Options $6 3%
Nebraska Total Care $6 3%
New York Cancer Services Program $6 3%
Nextlevel Health $6 3%
Oregon Screenwise $6 3%
Pace Of Southwest Michigan $6 3%
Paramount Advantage $6 3%
Parkland Community Health Plan $6 3%
Partners Behavioral Lme $6 3%
Peach State Healthplan $6 3%
Philadelphia County Funding $6 3%
Presbyterian Centennial Care $6 3%
Prestige Health Choice $6 3%
Priority Partners $6 3%
Robert F Sing Program $6 3%
Rx 340B Pass Along $6 3%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $6 3%
Rx Medi-Cal $6 3%
Rx Meridian Rx $6 3%
Ryan White Florida Mssrp $6 3%
Sandhills Center Lme $6 3%
Screening For Life $6 3%
St Joseph County Hlth Dpt $6 3%
Stephenson Cty Health $6 3%
Sunshine State Health Plan $6 3%
Superior Health $6 3%
Tenncare $6 3%
Texas Children'S Health Plan $6 3%
Tricare $6 - $7 3%
Trillium Community Ohp $6 3%
Triwest Health Alliance $6 - $7 3%
Tufts Health Public Plans $6 3%
UnitedHealthcare $6 - $103 3%
Us Family Health Plan $6 - $7 3%
Vaya Health Lme $6 3%
Veterans Eval Services $6 - $7 3%
Washtenaw Health Plan $6 3%
Wellsense Health Plan $6 3%
Wi Womens Wellness $6 3%
Align Senior Care $7 - $28 3%
Cca - Zing Health $7 - $9 3%
Medicare (plans) $7 - $28 3%
Veterans Administration $7 - $8 3%
Access Health $8 - $20 4%
Longevity Ipa Of Michigan Llc Health Plan Isnp $8 - $32 4%
1199 National Benefit Fund $9 - $98 4%
Allied National Global Care $9 - $98 4%
Asrm - Reliance Standard Life Insurance $9 - $98 4%
Christian Care Ministry $9 - $98 4%
Dean Health $9 - $98 4%
Fallon Health $9 - $98 4%
Family Life Insurance Company $9 - $98 4%
International Benefit Administrators $9 - $98 4%
Lifetime Benefit Solutions $9 - $98 4%
Manhattan Life $9 - $98 4%
Molina Marketplace $9 - $47 4%
Multiplan $9 - $98 4%
Mvp $9 - $98 4%
Oscar $9 - $35 4%
Pai $9 - $98 4%
Pan-American Life $9 - $98 4%
Phcs $9 - $98 4%
Trinity Health Share $9 - $98 4%
Wc Accident Fund $9 - $90 4%
Wc Advantage $9 - $90 4%
Wc Aig $9 - $90 4%
Wc Allied $9 - $90 4%
Wc Amerisure $9 - $90 4%
Wc Amtrust $9 - $90 4%
Wc Asu Risk Mgt $9 - $90 4%
Wc Berkley Admin $9 - $90 4%
Wc Broadspire $9 - $90 4%
Wc Bunch & Associates $9 - $90 4%
Wc Ccmsi $9 - $90 4%
Wc Emc Insurance Company $9 - $90 4%
Wc Esis $9 - $90 4%
Wc Fcci $9 - $90 4%
Wc Federated $9 - $90 4%
Wc Gallagher Bassett $9 - $90 4%
Wc Genex Care For Ohio $9 - $90 4%
Wc Guard Insurance Company $9 - $90 4%
Wc Hartford $9 - $90 4%
Wc Liberty Mutual $9 - $90 4%
Wc Meijers $9 - $90 4%
Wc Michigan $9 - $90 4%
Wc Mitchell Frankenmuth $9 - $90 4%
Wc Pma $9 - $90 4%
Wc Sedgwick $9 - $90 4%
Wc Sentry $9 - $90 4%
Wc Travelers $9 - $90 4%
Wc Tristar $9 - $90 4%
Wc Walmart $9 - $90 4%
Wc Zurich $9 - $90 4%
Wellpath $9 - $328 4%
Andrie Inc $10 - $12 4%
East Greenbush Central School District $10 - $12 4%
Genex Wc $10 - $12 4%
Healthsmart Workers Comp $10 - $12 4%
Jag Source $10 - $12 4%
New York State Insurance Fund $10 - $12 4%
Njm Insurance Group $10 - $12 4%
Partners Direct Health - Brio $10 - $12 4%
Rx Heatlhcomp $10 - $12 4%
Rx Restat $10 - $12 4%
Rx Saif Opdp Wc $10 - $12 4%
Rx Worker'S Comp $10 - $12 4%
Wc Ace $10 - $12 4%
Wc Acs Federal Employees $10 - $12 4%
Wc Acuity $10 - $12 4%
Wc Aegis $10 - $12 4%
Wc Aims $10 - $12 4%
Wc Alaska National Ins $10 - $12 4%
Wc Align Network $10 - $12 4%
Wc Am Trust N America $10 - $12 4%
Wc American Claims Mgmt $10 - $12 4%
Wc Benetech $10 - $12 4%
Wc Broward County $10 - $12 4%
Wc California State Comp Ins $10 - $12 4%
Wc California State Ins Fund $10 - $12 4%
Wc Capitol Area Health Consortium $10 - $12 4%
Wc Chartis $10 - $12 4%
Wc Chubb $10 - $12 4%
Wc Cirma $10 - $12 4%
Wc City Of Albany $10 - $12 4%
Wc City Of Sioux City $10 - $12 4%
Wc Claims Mgmt Inc $10 - $12 4%
Wc Cna $10 - $12 4%
Wc Comp One Admin C/O Manageability $10 - $12 4%
Wc Compone Admin $10 - $12 4%
Wc Corvel $10 - $12 4%
Wc Ct Healthcare Trust $10 - $12 4%
Wc Donegal Insurance Group $10 - $12 4%
Wc Employee Mutual $10 - $12 4%
Wc Enablecomp $10 - $12 4%
Wc Encore Health Network $10 - $12 4%
Wc Erie $10 - $12 4%
Wc Evolutions $10 - $12 4%
Wc Fed Ex $10 - $12 4%
Wc Federal Black Lung $10 - $12 4%
Wc Finley Occupational Health $10 - $12 4%
Wc First Agency/Occunet $10 - $12 4%
Wc Ford Motor $10 - $12 4%
Wc Fresno Unified Emp $10 - $12 4%
Wc General Motors $10 - $12 4%
Wc Generic $10 - $12 4%
Wc Great West Casualty $10 - $12 4%
Wc Guarantee Insurance $10 - $12 4%
Wc Hab $10 - $12 4%
Wc Hastings $10 - $12 4%
Wc Health Management $10 - $12 4%
Wc Heritage Summit $10 - $12 4%
Wc Hireright $10 - $12 4%
Wc Horizon $10 - $12 4%
Wc Icw Group $10 - $12 4%
Wc Idaho State Ins Fund $10 - $12 4%
Wc Intercare Insurance $10 - $12 4%
Wc Intermountain $10 - $12 4%
Wc Johns Eastern $10 - $12 4%
Wc Kemberton $10 - $12 4%
Wc Key Ins & Benefit Solutions $10 - $12 4%
Wc Mac Risk Management $10 - $12 4%
Wc Massachusetts $10 - $12 4%
Wc Mdia $10 - $12 4%
Wc Meadowbrook Claim $10 - $12 4%
Wc Medical Administrators $10 - $12 4%
Wc Memic $10 - $12 4%
Wc Mercy Workcare $10 - $12 4%
Wc Michigan Millers Mutual $10 - $12 4%
Wc Mra $10 - $12 4%
Wc Nationwide $10 - $12 4%
Wc Nca Comp $10 - $12 4%
Wc New York $10 - $12 4%
Wc New York Special Funds $10 - $12 4%
Wc North American Rishces $10 - $12 4%
Wc Northeast Health $10 - $12 4%
Wc Notre Dame $10 - $12 4%
Wc Novanet $10 - $12 4%
Wc O'Hara Corp $10 - $12 4%
Wc Occ Health Allen $10 - $12 4%
Wc Ohio Bureau $10 - $12 4%
Wc One Call Medical $10 - $12 4%
Wc Paradigm $10 - $12 4%
Wc Peerless $10 - $12 4%
Wc Praxis Health Network $10 - $12 4%
Wc Price Chopper $10 - $12 4%
Wc Procura Management $10 - $12 4%
Wc Qualcare $10 - $12 4%
Wc Quiktrip $10 - $12 4%
Wc Reny Company $10 - $12 4%
Wc Rev Claims $10 - $12 4%
Wc Risico $10 - $12 4%
Wc Rural Mutual $10 - $12 4%
Wc Saif Oregon $10 - $12 4%
Wc Secura $10 - $12 4%
Wc Sheakley Unicomp $10 - $12 4%
Wc Smile Lodge $10 - $12 4%
Wc Society $10 - $12 4%
Wc Srs $10 - $12 4%
Wc Taconic (Mro) $10 - $12 4%
Wc Taconic Farms $10 - $12 4%
Wc Triad Group $10 - $12 4%
Wc Troy Ny $10 - $12 4%
Wc Tyson $10 - $12 4%
Wc Unified Health Services $10 - $12 4%
Wc United Heartland $10 - $12 4%
Wc Us Dept Of Labor $10 - $12 4%
Wc Velocity $10 - $12 4%
Wc West Bend $10 - $12 4%
Wc West Bend Mutual/Argent $10 - $12 4%
Wc Winnebago Industries $10 - $12 4%
Wc Yankee Trails $10 - $12 4%
Wc York Risk $10 - $12 4%
Wc Zenith $10 - $12 4%
Blue Benefit Administrators Of Massachusetts $11 - $97 5%
Blue Distinction Transplant $11 - $97 5%
Blue Shield - Ca $11 - $97 5%
Blue Shield - Id (Regence) $11 - $97 5%
Blue Shield - Ny Highmark Northeastern $11 - $97 5%
Blue Shield - Ny Highmark Western $11 - $97 5%
Blue Shield - Pa (Highmark) $11 - $97 5%
Blue Shield - Wa (Regence) $11 - $97 5%
Claimdoc $11 - $12 5%
Kent County Jail $11 - $12 5%
Muskegon County Jail $11 - $12 5%
Nomi Health $11 - $64 5%
Blue Care Network $12 - $97 5%
Meritain $12 - $91 5%
Acclaim $13 - $102 6%
Administrative Concepts $13 - $102 6%
Allegeant $13 - $102 6%
Allied Benefit Systems $13 - $102 6%
Ameriben $13 - $102 6%
American Family $13 - $102 6%
American Healthcare Alliance $13 - $102 6%
American National $13 - $20 6%
American Postal Workers Secondary $13 - $15 6%
American Republic $13 - $102 6%
Amerihealth $13 - $102 6%
Aultcare $13 - $102 6%
Automated Benefit Services $13 - $102 6%
Auxiant $13 - $102 6%
Benefit Administrative Systems,Llc $13 - $102 6%
Boon Chapman $13 - $102 6%
Cam Administrative Services $13 - $102 6%
Christian Brother Services $13 - $102 6%
Christian Brothers Holy Cross $13 - $102 6%
Claimchoice Adminstrators $13 - $102 6%
Comprehensive Benefits $13 - $102 6%
Consociate $13 - $102 6%
Continental Life Insurance $13 - $102 6%
Coventry $13 - $20 6%
Custom Benefit Administrators $13 - $102 6%
Cypress Benefit Administrators $13 - $102 6%
Employee Benefit Concepts $13 - $102 6%
Employee Benefit Management $13 - $102 6%
Enterprise Group Planning $13 - $102 6%
First Health $13 - $103 6%
Forest County Potawatomi $13 - $102 6%
Freedom Life Insurance Company $13 - $102 6%
Group Administrators $13 - $102 6%
Group Marketing Services $13 - $102 6%
Group Pension Administrators $13 - $98 6%
Guardian $13 - $102 6%
Health America $13 - $102 6%
Health Choices $13 - $102 6%
Health Smart $13 - $102 6%
Healthcare Management Admin $13 - $20 6%
Healthez $13 - $102 6%
Healthgram $13 - $102 6%
Healthscope $13 - $102 6%
Insight $13 - $102 6%
Intercare $13 - $102 6%
Jfp Benefit Management $13 - $102 6%
Jp Farley Corporation $13 - $102 6%
Key Benefit Administrator $13 - $102 6%
Liberty Union Life Assurance Co $13 - $102 6%
Lucent Health $13 - $102 6%
Luminare Health $13 - $102 6%
Luminare Health (Detroit) $13 - $102 6%
Magnacare $13 - $20 6%
Medben $13 - $102 6%
Medcost $13 - $102 6%
Medical Mutual $13 - $102 6%
Mutual Health Services $13 - $102 6%
Mutual Of Omaha $13 - $102 6%
Ncas $13 - $102 6%
Nippon Life Ins $13 - $102 6%
Nova $13 - $102 6%
Painters Union Insurance Fund $13 - $102 6%
Physicians Mutual $13 - $102 6%
Plumbers Local 98 Insurance Fund $13 - $102 6%
Prairie States $13 - $102 6%
Preferred One $13 - $20 6%
Primary Physician Care $13 - $102 6%
Professional Benefit Administrators $13 - $102 6%
Secureone Preferred United Plans $13 - $102 6%
Siho Insurance Services $13 - $20 6%
Sisco Benefits $13 - $20 6%
The Health Plan $13 - $20 6%
The Loomis Company $13 - $102 6%
Trustmark Small Business Benefits $13 - $102 6%
Unicare $13 - $102 6%
Unified Group Services $13 - $102 6%
Valenz $13 - $102 6%
Webtpa $13 - $20 6%
Western & Southern Financial Group $13 - $102 6%
Wps $13 - $102 6%
Priority Health $14 - $103 6%
U Of M Health Plan $16 - $102 7%
Geha $17 - $103 8%
Hap $18 - $105 8%
Health Partners $18 8%
Tufts Health Plan $18 8%
Asr Health Benefits $22 - $95 10%
Bcccp-Michigan $23 - $34 10%
Us Health And Life $23 - $102 10%
Varipro $23 - $105 10%
Blue Care Network Advantage $28 13%
Correctional Recovery $28 13%
Vitalcore $38 17%
Hospice Of Michigan $63 28%
Bcn Domestic $97 43%
Kaiser Domestic $97 43%
Ghc Scw $98 44%
Medi Share $98 44%
Paramount Hmo $98 44%
Caresource $102 46%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 72 South State Street, Shelby, MI 49455
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals