CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Wilcox Memorial Hospital

Billing Code: 94640 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$153

about 0.7× the $224 Medicare rate · typically $32–$246

modeled estimate · not a bill or quote

What this hospital charges insurers

$212

Above the fair price

about $59 over the fair price · 0.9× Medicare

Medicare pays $224 Fair price $153 This hospital $212 Cash price $248 Hospital's list price $413

How we calculate the fair BaseRate →

How this hospital compares to other HI hospitals

One of the lower prices — 7 of 8 other HI hospitals charge more for the same procedure.

Cheapest $203 Priciest $366

Black dot = this hospital, among the 9 HI hospitals with a price for this procedure. Full list below.

A fair price for a Breathing treatment (nebulizer) is about $153 (about 0.7× the $224 Medicare rate). Wilcox Memorial Hospital charges insurers about $212, or about $248 in cash — above the fair price. Located in Lihue, HI.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $153. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Kaiser Permanente Blue Cross Blue ShieldAetnaCignaHumana

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$13 - $129	6%
Kaiser Permanentemajor	$133 - $444	59%
Devoted Health	$270	121%
+ 7 smaller / regional plans	$9 - $2,624

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 248), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 94640.

Insurance Before you use insurance

Call your insurance company to confirm Wilcox Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 94640.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Wilcox Memorial Hospital

Compare: Breathing treatment (nebulizer) at other HI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.