CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: St Marys Hospital Superior

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $65
  • Cash Discount Price: $100
  • vs. Medicare Baseline: 0.29x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at St Marys Hospital Superior is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.29x the Medicare baseline. Located in 3500 Tower Ave, Superior, WI.
Cash / Self-Pay
$100

Average discount available for prompt cash payment at this facility.

Insurance Median
$65

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: $100 (45%)
Insurance Median: $65 (29%)
Cash: $100 (45% of Medicare)
Ins. Median: $65 (29% 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
Advocare/Security Health $21 - $65 9%
Blue Cross Blue Shield $21 - $163 9%
Freedom Blue Ppo $21 - $65 9%
Healthpartners Care Msho / Mcr Adv $21 - $65 9%
Imcare Msho Pcc Prime $21 - $65 9%
Imcare Msho Ref Req $21 - $65 9%
Medica Advantage Solutions $21 - $65 9%
Medica Msho/Dual Solutions $21 - $65 9%
Medica Prime Solution Group $21 - $65 9%
Medica Uplan $21 - $65 9%
Medicare (plans) $21 - $65 9%
Nd Va Administration $21 - $65 9%
Platinum Blue/Vantage Blue $21 - $65 9%
Primewest Msho $21 - $65 9%
Secure Blue Msho $21 - $65 9%
Ubh Cost Plan $21 - $65 9%
Ubh Msho $21 - $65 9%
Ucare Msho $21 - $65 9%
UnitedHealthcare $21 - $184 9%
Blue Plus Pmap Pcc Prime $26 - $112 12%
Healthpartners Care Pmap $27 - $82 12%
Medica Access $27 - $127 12%
Sanford Healthplan $29 - $92 13%
Ucare $44 - $134 20%
Healthpartners $45 - $162 20%
Medica $47 - $159 21%
Wea $48 - $156 21%
America'S Ppo $52 - $157 23%
Cigna $52 - $162 23%
Healthpartners Pcc Prime $52 - $162 23%
Security Health $52 - $156 23%
Medica Choice $54 - $163 24%
Wps $56 - $171 25%
Aetna $57 - $173 25%
Healtheos $58 - $175 26%
Itasca Med Care $203 91%
Primewest $206 92%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3500 Tower Ave, Superior, WI 54880
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals