CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Salem Memorial District Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $225
  • Cash Discount Price: $323
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Salem Memorial District Hospital is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $323. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.01x the Medicare baseline. Located in Po Box 774, Salem, MO.
Cash / Self-Pay
$323

Average discount available for prompt cash payment at this facility.

Insurance Median
$225

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: $323 (144%)
Insurance Median: $225 (101%)
Cash: $323 (144% of Medicare)
Ins. Median: $225 (101% 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 $85 - $549 38%
Ambetter / Centene $85 - $207 38%
Blue Cross Blue Shield $85 - $488 38%
Humana $85 - $518 38%
Tricare $85 - $207 38%
Triwest $85 - $207 38%
UnitedHealthcare $85 - $305 38%
Veteran'S Affairs $85 - $207 38%
Right Choice-Alliance $88 - $580 39%
Right Choice-Regular $100 - $592 45%
Healthlink $162 - $396 72%
First Health $200 - $488 89%
Mercy - C.B. Management Company/Joplin Supply Company $200 - $488 89%
Mercy - City Of Springfield $200 - $488 89%
Mercy - Clayco $200 - $488 89%
Mercy - Commerce Bank $200 - $488 89%
Mercy - Diversified Plastics $200 - $488 89%
Mercy - Employers Benefit Alliance $200 - $488 89%
Mercy - Evolutions $200 - $488 89%
Mercy - Fabick Cat $200 - $488 89%
Mercy - Firsthealth Network $200 - $488 89%
Mercy - Health Management Network $200 - $488 89%
Mercy - Health Systems Inc $200 - $488 89%
Mercy - Liberty Utilities/Empire District Electric $200 - $488 89%
Mercy - Life Church $200 - $488 89%
Mercy - Missouri State University $200 - $488 89%
Mercy - Prime Health Services $200 - $488 89%
Mercy - Quiktrip Corporation $200 - $488 89%
Mercy - Shinesolar $200 - $488 89%
Mercy - Springfield Public Schools $200 - $488 89%
Mercy - Springfield Remanufacturing $200 - $488 89%
Mercy - Sumnerone $200 - $488 89%
Mercy - Trailiner $200 - $488 89%
Mercy - Walmart Mercy Accountable Care Plan $200 - $488 89%
Mercy-American Healthcare Alliance $200 - $488 89%
Phcs $200 - $518 89%
Cigna $212 - $432 95%
Mercy - Compresults $225 - $549 101%
Mercy - Corvel Corporation $225 - $549 101%
Mercy - Novasys $225 - $549 101%
Mercy - Scurlock Industries $225 - $549 101%
Mercy - Usa Managed Care Organization $225 - $549 101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Po Box 774, Salem, MO 65560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals