CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: New Ulm Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $178
Cash Discount Price: $160
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at New Ulm Medical Center is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.80x the Medicare baseline. Located in 1324 Fifth North Street, New Ulm, MN.

Cash / Self-Pay

$160

Average discount available for prompt cash payment at this facility.

Insurance Median

$178

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: $160 (72%)

Insurance Median: $178 (80%)

Cash: $160 (72% of Medicare)

Ins. Median: $178 (80% 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
Ucare Pmap (A B C D E G N O S U R H)	$35 - $68	16%
Blue Cross Blue Shield	$41 - $237	18%
Medica Health System	$55 - $274	25%
Medicaid / KanCare	$76 - $209	34%
Medica	$77 - $260	34%
Medicare (plans)	$77 - $226	34%
South Country Health Alliance	$86 - $90	38%
Aetna	$106 - $214	47%
Medica Ubh (N)	$121 - $145	54%
Americas Ppo (Araz)(B D N O R S V)	$133	59%
Bc Aware/Blue Plus (Nr)	$135	60%
Medica Ubh Pmap	$138 - $268	62%
Cigna	$141 - $509	63%
Americas Ppo (Araz) (B D N H O R S)	$145	65%
First Health (A C E G H U B D N O R S)	$145 - $282	65%
Medica Dual Solutions (A U)	$148 - $149	66%
All Other Contracted Care (A B C D E G H N O R S U)	$173	77%
Health Partners	$185 - $467	83%
UnitedHealthcare	$202 - $261	90%
Americas Ppo (Araz)(A M U)	$224 - $225	100%
Medica Ubh (A)	$234 - $282	105%
Hennepin Health	$238	106%
Medica Mhps	$259 - $260	116%

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 $160.
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 New Ulm 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.