CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Lodi Community Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $437
  • Cash Discount Price: $528
  • vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Lodi Community Hospital is $437. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $528. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.95x the Medicare baseline. Located in 225 Elyria Street, Lodi, OH.
Cash / Self-Pay
$528

Average discount available for prompt cash payment at this facility.

Insurance Median
$437

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: $528 (236%)
Insurance Median: $437 (195%)
Cash: $528 (236% of Medicare)
Ins. Median: $437 (195% 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
UnitedHealthcare $76 - $504 34%
Buckeye $80 36%
Caresource $80 36%
Blue Cross Blue Shield $84 - $665 38%
Molina $84 38%
United $84 - $580 38%
Amerihealth $88 39%
Humana $244 109%
Mmo $244 - $435 109%
Summacare $244 - $498 109%
Oscar $245 - $313 110%
Aetna $276 - $813 123%
The Health Plan $325 - $650 145%
Amish Community Aid Plan $366 - $406 164%
Ohcp $395 177%
Aultcare $406 181%
Omas $406 181%
Ohio Healthy $439 196%
Php $488 218%
Phphi $488 218%
Upmc $488 218%
Cigna $524 234%
Cc Ehp $546 244%
Gms $569 254%
Medical Benefit Corp $569 254%
Consociate Health $610 273%
Frontpath $732 327%
Managed Care Services $732 327%
Multiplan $732 327%
Tertiary Care Network $732 327%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 Elyria Street, Lodi, OH 44254
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals