CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: St Joseph Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $218
  • Cash Discount Price: $218
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at St Joseph Medical Center is $218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $218. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Carondelet Dr, Kansas City, MO.
Cash / Self-Pay
$218

Average discount available for prompt cash payment at this facility.

Insurance Median
$218

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: $218 (97%)
Insurance Median: $218 (97%)
Cash: $218 (97% of Medicare)
Ins. Median: $218 (97% 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
UnitedHealthcare $10 - $687 4%
Medicaid / KanCare $173 77%
Home State $198 - $349 89%
Aetna $218 97%
Cigna $218 97%
Medicare (plans) $218 - $229 97%
Pace Kc (Swope Health Services) $218 97%
Tricare $218 97%
Veterans Evaluation Services $218 97%
Healthy Blue $229 - $231 102%
Kansas Superior $229 102%
Nhc Advantage $240 107%
Employer Direct Healthcare $306 137%
Blue Cross Blue Shield $349 - $404 156%
6 Degrees $437 195%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Carondelet Dr, Kansas City, MO 64114
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals