CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Indiana Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $228
  • Cash Discount Price: $283
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Indiana Regional Medical Center is $228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $283. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.02x the Medicare baseline. Located in 835 Hospital Road, Indiana, PA.
Cash / Self-Pay
$283

Average discount available for prompt cash payment at this facility.

Insurance Median
$228

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: $283 (126%)
Insurance Median: $228 (102%)
Cash: $283 (126% of Medicare)
Ins. Median: $228 (102% 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
Tricare $7 - $786 3%
Aetna $8 - $699 4%
Ambetter / Centene $8 - $314 4%
Amerihealth Caritas $8 - $236 4%
Cigna $8 - $542 4%
Geisinger Health Plan $8 - $236 4%
Highmark $8 - $629 4%
Highmark Wholecare $8 - $228 4%
Humana $8 - $225 4%
Medicare (plans) $8 - $228 4%
United Mine Workers Of America $8 - $228 4%
UnitedHealthcare $8 - $511 4%
Upmc Health Plan $8 - $362 4%
Geisinger $11 - $640 5%
Pa Health And Wellness Commercial $11 - $640 5%
Department Of Human Services And Torrance State Hospital $495 221%
Premier Comp Solutions, Llc $707 316%
Miscellaneous Commercial $786 351%
Pa Workers Compensation $786 351%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 835 Hospital Road, Indiana, PA 15701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals