CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Sanford Luverne Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $148
Cash Discount Price: $147
vs. Medicare Baseline: 0.66x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Sanford Luverne Medical Center is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.66x the Medicare baseline. Located in 1600 N Kniss Avenue P O Box 1019, Luverne, MN.

Cash / Self-Pay

$147

Average discount available for prompt cash payment at this facility.

Insurance Median

$148

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: $147 (66%)

Insurance Median: $148 (66%)

Cash: $147 (66% of Medicare)

Ins. Median: $148 (66% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$36 - $320	16%
Sanford Health Plan Align	$52 - $122	23%
Ucare	$56 - $304	25%
Aetna	$57 - $301	25%
Health Partners	$57 - $277	25%
Medicare (plans)	$57 - $132	25%
UnitedHealthcare	$57 - $289	25%
Primewest	$58 - $164	26%
Sanford Health Plan	$80 - $218	36%
Security Health Plan	$82 - $190	37%
Medica	$131 - $327	59%
Cigna	$134 - $311	60%
First Choice Health Network	$134 - $311	60%
Healthez	$134 - $311	60%
Multiplan	$134 - $311	60%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $147.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sanford Luverne Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.