CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Northeast Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $253
  • Cash Discount Price: $193
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Northeast Regional Medical Center is $253. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.13x the Medicare baseline. Located in 315 S Osteopathy, Kirksville, MO.
Cash / Self-Pay
$193

Average discount available for prompt cash payment at this facility.

Insurance Median
$253

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: $193 (86%)
Insurance Median: $253 (113%)
Cash: $193 (86% of Medicare)
Ins. Median: $253 (113% 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
Veterans Eval Services $7 3%
Self Pay $117 - $269 52%
Blue Cross Blue Shield $149 - $236 67%
Cigna $166 - $191 74%
Medicaid / KanCare $173 - $283 77%
Aetna $182 - $408 81%
Node Champva $221 99%
Tricare $221 99%
Medicare (plans) $231 103%
Node Hospice Non Par Agree $235 105%
Node Va $235 105%
UnitedHealthcare $235 - $367 105%
Node Devoted Health Mcr Adv $243 109%
Blue Pathway/Pathway X $246 110%
Centurion Correctional $294 131%
Us Department Of Labor $294 131%
Access Health Services, Llc $318 142%
Healthlink $367 - $391 164%
Multiplan $367 - $391 164%
Coventry Wc $391 175%
Home State Exchange $423 189%
Naphcare $446 199%
Immergrun $470 210%
Blue Prefrerred $515 230%
Blue Access $531 237%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 S Osteopathy, Kirksville, MO 63501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals