CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Essentia Health Fosston

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $79
  • Cash Discount Price: $100
  • vs. Medicare Baseline: 0.35x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Essentia Health Fosston is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.35x the Medicare baseline. Located in 900 Hilligoss Boulevard Se, Fosston, MN.
Cash / Self-Pay
$100

Average discount available for prompt cash payment at this facility.

Insurance Median
$79

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: $100 (45%)
Insurance Median: $79 (35%)
Cash: $100 (45% of Medicare)
Ins. Median: $79 (35% 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
Healthpartners Care Pmap $26 - $79 12%
Medica Access $27 - $126 12%
Sanford Health Plan $29 - $92 13%
Advocare/Security Health $34 - $102 15%
Blue Cross Blue Shield $34 - $177 15%
Freedom Blue Ppo $34 - $102 15%
Healthpartners Care Msho / Mcr Adv $34 - $102 15%
Imcare Msho Pcc Prime $34 - $102 15%
Imcare Msho Ref Req $34 - $102 15%
Medica Advantage Solutions $34 - $102 15%
Medica Msho/Dual Solutions $34 - $102 15%
Medica Prime Solution Group $34 - $102 15%
Medicare (plans) $34 - $102 15%
Nd Va Administration $34 - $102 15%
Platinum Blue/Vantage Blue $34 - $102 15%
Primewest Msho $34 - $102 15%
Secure Blue Msho $34 - $102 15%
Ubh Cost Plan $34 - $102 15%
Ubh Msho $34 - $102 15%
Ucare Msho $34 - $102 15%
UnitedHealthcare $34 - $184 15%
Blue Plus Pmap Pcc Prime $37 - $177 17%
Healthpartners $41 - $135 18%
Ucare $44 - $134 20%
Cigna $45 - $135 20%
Healthpartners Pcc Prime $45 - $135 20%
Wea $48 - $156 21%
America'S Ppo $52 - $157 23%
Medica $56 - $178 25%
Medica Uplan $56 - $169 25%
Wps $56 - $171 25%
Aetna $57 - $173 25%
Medica Choice $60 - $183 27%
Itasca Med Care $203 91%
Primewest $206 92%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 900 Hilligoss Boulevard Se, Fosston, MN 56542
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals