CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $303
  • Cash Discount Price: $389
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $389. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.35x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.
Cash / Self-Pay
$389

Average discount available for prompt cash payment at this facility.

Insurance Median
$303

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: $389 (174%)
Insurance Median: $303 (135%)
Cash: $389 (174% of Medicare)
Ins. Median: $303 (135% 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
Humana $194 - $364 87%
Managed Health Services $194 87%
Molina Healthcare Of Wi $194 - $348 87%
Network Health Plan $194 - $342 87%
Quartz $194 - $233 87%
Security Health Plan (Shp) $194 - $236 87%
UnitedHealthcare $194 - $306 87%
Veteran'S Administration (Va Ccn) $194 87%
Blue Cross Blue Shield $200 - $303 89%
Group Health Cooperative Of Eau Claire $206 - $389 92%
Icare $207 93%
The Alliance $208 93%
Amish/Mennonite $225 101%
Wps Health Insurance $275 123%
Cigna $278 - $303 124%
Health Payment Systems $285 127%
First Health $348 156%
Trilogy $368 164%
Healtheos By Multiplan Inc. $380 - $389 170%
Health Partners $389 174%
Coventry $393 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 707 S University Ave, Beaver Dam, WI 53916
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals