CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Beloit Health System

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $159
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 0.71x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Beloit Health System is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.71x the Medicare baseline. Located in 1969 W Hart Rd, Beloit, WI.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$159

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: $50 (22%)
Insurance Median: $159 (71%)
Cash: $50 (22% of Medicare)
Ins. Median: $159 (71% 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 $8 - $355 4%
Blue Cross Blue Shield $8 - $256 4%
Dean Health $8 - $230 4%
Independent Care Health Plan $8 - $230 4%
Quartz $8 - $256 4%
UnitedHealthcare $8 - $296 4%
Cook Children'S Health Plan (Cchp) $12 - $230 5%
Naphcare $13 - $346 6%
The Alliance $21 - $922 9%
Wea Trust $32 - $217 14%
Wps $34 - $292 15%
Multiplan $47 - $315 21%
Humana $49 - $857 22%
Health Eos $52 - $351 23%
Cigna $54 - $363 24%
Hfn $54 - $363 24%
Preferred Network Access $54 - $363 24%
Managed Health Services $230 103%
Molina Healthcare $230 103%
Wellcare $230 103%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1969 W Hart Rd, Beloit, WI 53511
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals