CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Merit Health River Oaks

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $354
  • Cash Discount Price: $174
  • vs. Medicare Baseline: 1.58x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Merit Health River Oaks is $354. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.58x the Medicare baseline. Located in 1030 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$174

Average discount available for prompt cash payment at this facility.

Insurance Median
$354

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: $174 (78%)
Insurance Median: $354 (158%)
Cash: $174 (78% of Medicare)
Ins. Median: $354 (158% 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 $65 - $2,082 29%
Medicaid / KanCare $98 - $1,189 44%
Cigna $128 - $1,552 57%
Self Pay $141 - $1,716 63%
Magnolia Mcd Chip $157 70%
Caresource Truecare $158 71%
Molina Chip $167 75%
Tricare $188 84%
Trimed Billing Solutions $193 - $2,340 86%
Humana $195 87%
Medicare (plans) $195 87%
Node First Choice Shared Health Of Ms Mcr Adv $195 87%
Node Vantage Health Mcr Adv $195 87%
Molina $198 89%
Node Champva $198 89%
Node Devoted Health Mcr Adv $198 89%
Node First Choice American Health Mcr Adv $198 89%
Node Hospice Non Par Agree $198 89%
Node Va $198 89%
Aetna $200 - $5,459 89%
Node First Choice Wellcare Mcr Adv $202 90%
Node Healthy Mississippi Mcr Adv $217 97%
Ms State Hospital Of Whitfield Ms $244 - $2,963 109%
Node Us Dept Of Labor $247 110%
Ms Work Comp $273 122%
Prime Health Wc $273 122%
Molina Exchange $295 132%
First Choice Standard $296 - $3,587 132%
First Choice Preferred $297 133%
Node First Choice Occunet $297 133%
Advanced Health Systems $319 143%
First Choice Coventry $334 - $4,055 149%
Node First Choice Seven Corners $336 150%
Magnolia Exchange $346 155%
First Choice Mpcn Standard $354 - $4,289 158%
First Choice Ppo Plus $354 - $4,289 158%
Phcs $386 - $4,679 173%
First Choice Lgp $431 193%
Vantage Health Commercial $445 199%
Blue Cross Blue Shield $446 199%
Benefit Administration Services $463 - $6,629 207%
Benefit Management Systems $463 - $6,629 207%
Citizens State Bank Inc $463 - $6,629 207%
First Choice Stratose $514 - $6,239 230%
Prime Health Services $514 - $6,239 230%
American Health Group $547 - $6,629 245%
Beech Street $547 - $6,629 245%
Formost $547 - $6,629 245%
Usa Mco $547 - $6,629 245%
One Health Plan $579 - $7,019 259%
Ms Dept Of Rehabilitation Services $643 - $7,381 287%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1030 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals