CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Howard County Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $130
  • Cash Discount Price: $260
  • vs. Medicare Baseline: 0.58x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Howard County Medical Center is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.58x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.
Cash / Self-Pay
$260

Average discount available for prompt cash payment at this facility.

Insurance Median
$130

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: $260 (116%)
Insurance Median: $130 (58%)
Cash: $260 (116% of Medicare)
Ins. Median: $130 (58% 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 $6 - $7 3%
Aetna $7 - $250 3%
Blue Cross Blue Shield $7 - $250 3%
Great Plains $7 - $150 3%
Medica Chi $7 - $150 3%
Medica Elevate $7 - $14 3%
Medica Standard Premier $7 3%
Molina Healthcare $7 - $132 3%
Nebraska Total Care - Wellcare $7 3%
Tricare $7 - $197 3%
UnitedHealthcare $7 - $252 3%
Oscar Health $12 5%
Ambetter / Centene $14 6%
Beshp $14 6%
Midland'S Choice $14 6%
Nebraska Total Care $15 - $132 7%
Medica Chi Aco $27 - $239 12%
Medica Choice National $27 - $239 12%
Medica Ifb Aco $29 - $252 13%
Medica Ifb Open Access $29 - $252 13%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: P O Box 406, 1113 Sherman St, St Paul, NE 68873
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals