CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Ochsner Stennis Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $168
  • Cash Discount Price: $259
  • vs. Medicare Baseline: 0.75x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Ochsner Stennis Memorial Hospital is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $259. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.75x the Medicare baseline. Located in 14365 Highway 16 West, De Kalb, MS.
Cash / Self-Pay
$259

Average discount available for prompt cash payment at this facility.

Insurance Median
$168

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: $259 (116%)
Insurance Median: $168 (75%)
Cash: $259 (116% of Medicare)
Ins. Median: $168 (75% 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
Humana $5 - $317 2%
Cigna $7 - $317 3%
Magnolia Health Plan – Wellcare By All Well Of Mississippi $7 - $320 3%
Medicaid / KanCare $7 - $210 3%
Medicare (plans) $7 - $364 3%
Shared Health Mississippi $7 - $333 3%
UnitedHealthcare $7 - $269 3%
Prime Health Services Ppo $8 - $422 4%
Ambetter / Centene $9 - $320 4%
Primewell Health Services Commercial Exchange Plan $11 - $354 5%
Primewell Health Services – Commercial $11 - $354 5%
Blue Cross Blue Shield $12 - $535 5%
Aetna $18 - $343 8%
Claritev D/B/A Multiplan/Phcs/American Life Care $24 - $396 11%
Zelis $26 - $396 12%
Cor Vel $29 - $264 13%
Prime Health Services Ppo -Workers Comp $29 - $258 13%
Select Administrative Services Network $32 - $370 14%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 14365 Highway 16 West, De Kalb, MS 39328
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals