CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: North Hawaii Community Hospital, Inc

Billing Code: 94640 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$209

about 0.9× the $224 Medicare rate · typically $52–$276

modeled estimate · not a bill or quote

What this hospital charges insurers

$276

Above the fair price

about $67 over the fair price · 1.2× Medicare

Medicare pays $224 Fair price $209 This hospital $276 Cash price $317 Hospital's list price $453

How we calculate the fair BaseRate →

How this hospital compares to other HI hospitals

On the higher side — 7 of 8 other HI hospitals charge less.

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 $209 (about 0.9× the $224 Medicare rate). North Hawaii Community Hospital, Inc charges insurers about $276, or about $317 in cash — above the fair price. Located in Kamuela, 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 $209. 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	$276	123%
Kaiser Permanentemajor	$276 - $772	123%
+ 7 smaller / regional plans	$17 - $3,709

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 317), 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 North Hawaii Community Hospital, Inc 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 North Hawaii Community Hospital, Inc

Compare: Breathing treatment (nebulizer) at other HI hospitals

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