CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Merit Health Women's Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $217
  • Cash Discount Price: $201
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Merit Health Women's Hospital is $217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $201. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.97x the Medicare baseline. Located in 1026 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$201

Average discount available for prompt cash payment at this facility.

Insurance Median
$217

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: $201 (90%)
Insurance Median: $217 (97%)
Cash: $201 (90% of Medicare)
Ins. Median: $217 (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
Veterans Eval Services $7 3%
UnitedHealthcare $103 - $417 46%
Medicaid / KanCare $136 - $157 61%
Magnolia Mcd Ms Chip $157 70%
Caresource Truecare $158 71%
Molina Chip $167 75%
Tricare $188 84%
Cigna $194 87%
Humana $195 87%
Medicare (plans) $195 87%
Node Shared Health Of Ms Mcr Adv $195 87%
Node Vantage Health Mcr Adv $195 87%
Node Windsor Mcr Adv $195 87%
Self Pay $196 88%
Node Champva $198 89%
Node Devoted Health Mcr Adv $198 89%
Node First Choice American Health Of Ms Mcr Adv $198 89%
Node Molina Mcr Adv $198 89%
Node Va $198 89%
Aetna $200 - $624 89%
Node First Choice Wellcare Mcr Adv $202 90%
Node Healthy Mississippi Mcr Adv $217 97%
Node Us Dept Of Labor $247 110%
Trimed Billing Solutions $268 120%
Ms Work Comp $273 122%
Molina Exchange $295 132%
Advanced Health Systems $297 133%
First Choice Preferred $297 133%
Occunet $297 133%
Node First Choice Seven Corners $336 150%
State Hospital $339 152%
Magnolia Exchange $346 155%
First Choice Mpcn $401 179%
First Choice Standard $410 183%
First Choice Lgp $431 193%
Vantage Health $445 199%
Coventry First Health $464 207%
Blue Cross Blue Shield $472 211%
First Choice Ppo Plus $491 219%
Benefit Management Systems $642 - $758 287%
First Choice Stratose $714 319%
Health Choice Of Mississippi $714 319%
Prime Health Services $714 319%
Mississippi Department Of Rehabilitation Services $892 399%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1026 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals