CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Huron Regional Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $752
Cash Discount Price: $795
vs. Medicare Baseline: 3.36x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Huron Regional Medical Center is $752. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $795. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 3.36x the Medicare baseline. Located in 172 Fourth Street Se, Huron, SD.

Cash / Self-Pay

$795

Average discount available for prompt cash payment at this facility.

Insurance Median

$752

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: $795 (355%)

Insurance Median: $752 (336%)

Cash: $795 (355% of Medicare)

Ins. Median: $752 (336% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 336% of the Medicare baseline (a markup of 236%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Avera	$11	5%
Sanford	$18 - $1,806	8%
Midlands	$33	15%
UnitedHealthcare	$39 - $1,398	17%
Wellmark	$218	97%
Multiplan	$241 - $1,747	108%
Medica	$242 - $1,753	108%
Healthpartners	$257 - $1,864	115%
Americas	$260 - $1,883	116%
First Choice Of The Midwest	$260 - $1,883	116%
First Health Coventry	$260 - $1,883	116%
Integrated Health Plan	$260 - $1,883	116%
Tlc Advantage	$260 - $1,883	116%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $795.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Huron Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.