CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Mosaic Life Care at St Joseph

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $205
  • Cash Discount Price: $234
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Mosaic Life Care at St Joseph is $205. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.92x the Medicare baseline. Located in 5325 Faraon Street, Saint Joseph, MO.
Cash / Self-Pay
$234

Average discount available for prompt cash payment at this facility.

Insurance Median
$205

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: $234 (105%)
Insurance Median: $205 (92%)
Cash: $234 (105% of Medicare)
Ins. Median: $205 (92% 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
Aetna $7 - $227 3%
Blue Cross Blue Shield $7 - $239 3%
UnitedHealthcare $7 - $388 3%
Medicaid / KanCare $10 - $69 4%
Ambetter / Centene $13 - $389 6%
Amerigroup Of Iowa $17 8%
Iowa Total Care $17 8%
Molina Of Iowa $17 8%
Centurion $27 - $192 12%
Geha Shared Services $31 - $223 14%
Cigna $33 - $242 15%
Freedom Select Healthlink $33 - $236 15%
Healthlink Open Access $33 - $236 15%
Preferred Health Professional $33 - $236 15%
Sisco $33 - $236 15%
Multiplan $39 - $248 17%
Home State Of Missouri $399 178%
Healthy Blue Of Missouri $490 219%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5325 Faraon Street, Saint Joseph, MO 64506
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals