CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Vandalia Health Broaddus Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $237
  • Cash Discount Price: $193
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Vandalia Health Broaddus Hospital is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.06x the Medicare baseline. Located in 1 Healthcare Drive Mansfield Hill, Philippi, WV.
Cash / Self-Pay
$193

Average discount available for prompt cash payment at this facility.

Insurance Median
$237

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: $193 (86%)
Insurance Median: $237 (106%)
Cash: $193 (86% of Medicare)
Ins. Median: $237 (106% 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 $5 - $247 2%
Correctional Medical Systems $5 2%
The Health Plan $5 - $248 2%
Unicare $5 2%
Blue Cross Blue Shield $11 - $196 5%
Peak Health $48 - $88 21%
Highmark $202 90%
UnitedHealthcare $204 - $268 91%
Humana $212 95%
West Virginia Senior Advantage $214 96%
Cigna $242 108%
First Health $247 110%
Geisenger Health Plan $257 115%
Health Network America $257 - $262 115%
Multiplan/Phcs $259 116%
Geha $262 117%
Selectnet $270 121%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Healthcare Drive Mansfield Hill, Philippi, WV 26416
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals