CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Mercy Health Rehabilitation Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $101
  • Cash Discount Price: $101
  • vs. Medicare Baseline: 0.45x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Mercy Health Rehabilitation Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.45x the Medicare baseline. Located in 3180 Belmont Ave, Youngstown, OH.
Cash / Self-Pay
$101

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $101 (45%)
Insurance Median: $101 (45%)
Cash: $101 (45% of Medicare)
Ins. Median: $101 (45% 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
Medical Mutual Nas $38 - $98 17%
Aultcare $47 - $122 21%
Multiplan $58 - $150 26%
Aetna $69 - $179 31%
Ambetter / Centene $69 - $179 31%
Blue Cross Blue Shield $69 - $179 31%
Caresource Exchange $69 - $179 31%
Cigna $69 - $179 31%
Devoted $69 - $179 31%
Highmark Ppo Commercial $69 - $179 31%
Highmark Ppo Exchange $69 - $179 31%
Humana $69 - $179 31%
Medicaid / KanCare $69 - $179 31%
Medical Mutual Exchange $69 - $179 31%
Medical Mutual Medflex $69 - $179 31%
Medical Mutual New Biz $69 - $179 31%
Medical Mutual Supermed Commercial $69 - $179 31%
Medical Mutual Traditional Commercial $69 - $179 31%
Medicare (plans) $69 - $179 31%
Molina Exchange $69 - $179 31%
UnitedHealthcare $69 - $179 31%
Upmc $69 - $179 31%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3180 Belmont Ave, Youngstown, OH 44505
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL