CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Memorial Health Care Systems

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $124
Cash Discount Price: $170
vs. Medicare Baseline: 0.55x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Memorial Health Care Systems is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.55x the Medicare baseline. Located in 300 North Columbia Ave, Seward, NE.

Cash / Self-Pay

$170

Average discount available for prompt cash payment at this facility.

Insurance Median

$124

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: $170 (76%)

Insurance Median: $124 (55%)

Cash: $170 (76% of Medicare)

Ins. Median: $124 (55% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Molina Mcaid-All Plans	$77 - $117	34%
Ne Total Care Mcaid-All Plans	$77 - $117	34%
UnitedHealthcare	$77 - $213	34%
Beshp Mcr Adv - All Plans	$82 - $124	37%
Blue Cross Blue Shield	$82 - $206	37%
Medica Mcare Cost	$82 - $124	37%
Medica Mcr Adv	$82 - $124	37%
Tricare	$82 - $124	37%
Wellcare Mcr Adv - All Plans	$83 - $126	37%
Phcs Ppo-All Plans	$136 - $206	61%
Ambetter / Centene	$137 - $208	61%
Medica Comm-All Other Plans	$137 - $208	61%
Medica Elevate	$137 - $208	61%
Midlands Choice-All Plans	$139 - $210	62%
Aetna	$140 - $213	63%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $170.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Memorial Health Care Systems is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.