CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Black River Memorial Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $163
  • Cash Discount Price: $164
  • vs. Medicare Baseline: 0.73x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Black River Memorial Hospital is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.73x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.
Cash / Self-Pay
$164

Average discount available for prompt cash payment at this facility.

Insurance Median
$163

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: $164 (73%)
Insurance Median: $163 (73%)
Cash: $164 (73% of Medicare)
Ins. Median: $163 (73% 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 $7 - $346 3%
UnitedHealthcare $7 - $361 3%
Blue Cross Blue Shield $8 - $327 4%
Group Health Cooperative Of Eau Claire $11 - $361 5%
My Choice Wisconsin, Inc. $11 - $190 5%
Quartz Health Solutions, Inc $11 - $339 5%
Security Health Plan $11 - $347 5%
Corvel $13 - $227 6%
The Alliance $19 - $357 8%
Triology Health Solutions $20 - $353 9%
Association Benefits Solution $21 - $353 9%
Cigna $21 - $361 9%
Cofinity $21 - $361 9%
Coventry Health Care $21 - $361 9%
Custom Benefit Administrators $21 - $361 9%
Family Health Center Of Marshfield $21 - $353 9%
First Health Group Corporation $21 - $353 9%
Healthpartners, Inc. $21 - $361 9%
Medica $21 - $347 9%
Multiplan $21 - $368 9%
Provider Network Of America $21 - $353 9%
Wisconsin Physicians Service Insurance Corp $21 - $361 9%
Chorus $22 - $365 10%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 711 W Adams St, Black River Falls, WI 54615
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals