CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Alliancehealth Madill

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $417
  • Cash Discount Price: $187
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Alliancehealth Madill is $417. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.86x the Medicare baseline. Located in 901 S 5Th Ave, Madill, OK.
Cash / Self-Pay
$187

Average discount available for prompt cash payment at this facility.

Insurance Median
$417

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: $187 (84%)
Insurance Median: $417 (186%)
Cash: $187 (84% of Medicare)
Ins. Median: $417 (186% 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
Aetna $6 - $5,079 3%
Humana $6 - $1,312 3%
Medicaid / KanCare $6 3%
Node Us Dept Of Labor $11 5%
Preferred Community Choice Ppo $80 - $952 36%
Blue Cross Blue Shield $82 - $1,604 37%
Medicare (plans) $111 - $1,312 50%
Node Global Health Mcr Adv $111 - $1,312 50%
UnitedHealthcare $111 - $1,333 50%
Node Indian Health Service Managed Care $112 - $1,333 50%
Node Va $112 - $1,333 50%
Node Champva $116 - $1,373 52%
Tricare $116 - $1,373 52%
Self Pay $187 - $2,222 84%
Coventry $268 - $3,174 120%
Globalhealth $332 - $3,936 148%
Healthcare Highways $334 - $3,969 149%
Ok Work Comp $356 159%
Phcs $374 - $4,444 167%
Multiplan $401 - $4,952 179%
Healthchoice $407 182%
First Health $439 - $5,206 196%
Cigna $455 - $5,396 203%
Evolutions Healthcare Systems $455 - $5,396 203%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 S 5Th Ave, Madill, OK 73446
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals