CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Sanford Medical Center Aberdeen

Billing Code: 94640 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$148

about 0.7× the $224 Medicare rate · typically $91–$256

modeled estimate · not a bill or quote

Medicare pays $224 Fair price $148 Cash price $151 Hospital's list price $189

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$158 - $209	71%
Blue Cross Blue Shieldmajor	$209	93%
Aetnamajor	$155 - $209	69%
Health Net	$170	76%
HealthPartners	$105 - $209	47%
Medica	$162 - $174	72%
Sanford Health Plan	$84 - $193	38%
Security Health Plan	$104	46%
UCare	$148 - $207	66%
+ 2 smaller / regional plans	$170 - $214

Government programs also on file: Medicare.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 151), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 94640.

Insurance Before you use insurance

Call your insurance company to confirm Sanford Medical Center Aberdeen is in-network.
Ask your insurer whether prior approval is required for CPT code 94640.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Sanford Medical Center Aberdeen

Compare: Breathing treatment (nebulizer) at other SD hospitals

Insurance negotiated median for the same procedure, sorted lowest first.