CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Mercy Hospital Stoddard

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $70
  • Cash Discount Price: $59
  • vs. Medicare Baseline: 0.31x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Mercy Hospital Stoddard is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.31x the Medicare baseline. Located in 1200 N One Mile Rd, Dexter, MO.
Cash / Self-Pay
$59

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $59 (26%)
Insurance Median: $70 (31%)
Cash: $59 (26% of Medicare)
Ins. Median: $70 (31% 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
Medicaid / KanCare $5 - $244 2%
Blue Cross Blue Shield $15 - $1,287 7%
Health Alliance Contracted [320164] $20 - $72 9%
Aither Health Contracted [320449] $21 - $75 9%
Edison Health Solutions Contracted [320502] $21 - $75 9%
Healthlink Contracted [320179] $21 - $407 9%
Mercy Benefit Admin Contracted [320251] $21 - $304 9%
Mercy Benefit Admin [20251] $21 - $75 9%
Yuzu Health Contracted [320521] $21 - $75 9%
Aetna $23 - $181 10%
First Health Contracted [320128] $23 - $83 10%
Workers Comp [20426] $23 - $89 10%
Multiplan Contracted [320270] $25 - $89 11%
Private Health Care Systems Contracted [320320] $25 - $89 11%
Acentra Health Contracted [320527] $181 81%
Cross Timbers Hospice [20098] $181 81%
Dept Of Veteran Affairs Contracted [320106] $181 81%
Elara Caring Aspire Hospice Contracted [320433] $181 81%
Elara Caring Aspire Hospice [20433] $181 81%
Halo Hcr Inc Hospice Contracted [320432] $181 81%
Halo Hcr Inc Hospice [20432] $181 81%
Humana $181 81%
Kindful Hospice Contracted [320434] $181 81%
Kindful Hospice [20434] $181 81%
Medicare (plans) $181 - $191 81%
Mercy Hospice Okc [20252] $181 81%
Pace Of The Ozarks Contracted [320518] $181 81%
Tricare $181 81%
UnitedHealthcare $181 - $1,312 81%
Ambetter / Centene $184 82%
American Health Advantage Of Mo Mcr Hmo Contracted [320264] $184 82%
Home State Health Plan Contracted [320187] $184 82%
Hope Trust Contracted [320488] $184 82%
Provider Partners Health Plans Contracted [320450] $208 93%
Consociate Consolidated Health Contracted [320490] $253 - $407 113%
Auxiant Contracted [320462] $304 - $368 136%
Ebms Contracted [320493] $304 136%
Imagine 360 Contracted [320494] $304 136%
Reflect Health Contracted [320492] $315 141%
Cigna $322 144%
Preferred Health Plan Contracted [320522] $322 144%
United Medical Resources Contracted [320454] $1,312 586%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 N One Mile Rd, Dexter, MO 63841
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals