CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Holmes County Hospital and Clinics

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $16
  • Cash Discount Price: $8
  • vs. Medicare Baseline: 0.07x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Holmes County Hospital and Clinics is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.07x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.
Cash / Self-Pay
$8

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

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: $8 (4%)
Insurance Median: $16 (7%)
Cash: $8 (4% of Medicare)
Ins. Median: $16 (7% 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
Cigna $12 5%
Humana $12 5%
Tricare $12 5%
Mpcn-Lex $13 6%
Firstchoice-Lex $14 6%
Medadv_Uhc-Lex $14 6%
Ambetter / Centene $15 7%
Medadv_Primewell-Lex $15 7%
Medadv_Uhcdsnp-Lex $15 7%
Medicare (plans) $15 7%
Primewell-Lex $15 7%
United-Lex $15 7%
United-Options-Lex $15 7%
Va_Ccn-Lex $15 7%
Wellcare-Lex $15 7%
Devoted_Health-Lex $16 7%
Firsthealth-Lex $16 7%
Multiplan-Lex $16 7%
Ppoplus $16 7%
Aetna $17 8%
Phcs-Lex $18 8%
Advhealth-Lex $20 9%
Blue Cross Blue Shield $20 9%
Magnolia-Chip-Lex $20 9%
Molina-Chip-Lex $20 9%
Molina_Exchange-Lex $20 9%
Ms-Can-Magnolia-Lex $20 9%
Ms-Can-Molina-Lex $20 9%
Ms-Can-Truecare-Lex $20 9%
Truecare-Chip-Lex $20 9%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 239 Bowling Green Road, Lexington, MS 39095
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - State
  • Hospital Type: Critical Access Hospitals