CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Cherry County Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $346
Cash Discount Price: $361
vs. Medicare Baseline: 1.55x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Cherry County Hospital is $346. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $361. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.55x the Medicare baseline. Located in 510 North Green St, Valentine, NE.

Cash / Self-Pay

$361

Average discount available for prompt cash payment at this facility.

Insurance Median

$346

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: $361 (161%)

Insurance Median: $346 (155%)

Cash: $361 (161% of Medicare)

Ins. Median: $346 (155% 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
Ambetter / Centene	$4	2%
Molina Mcr Adv	$30 - $271	13%
Molina Mcaid - All Other Plans	$34 - $224	15%
Blue Cross Blue Shield	$53 - $346	24%
Midlands Choice-All Plans	$53 - $346	24%
UnitedHealthcare	$53 - $348	24%
Avera Aca Ppo	$54 - $350	24%
Avera Aso Ppo	$54 - $350	24%
Avera Hmo	$54 - $350	24%
Avera Non-Aca Ppo - All Other Plans	$54 - $350	24%
First Choice-All Plans	$54 - $350	24%
Multiplan-All Plans	$54 - $350	24%
Phcs-All Plans	$54 - $350	24%
Tlc Advantage-All Plans	$54 - $350	24%

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 $361.
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 Cherry County Hospital 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.