CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Geisinger-Lewistown Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $361
Cash Discount Price: $447
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Geisinger-Lewistown Hospital is $361. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $447. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.61x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$447

Average discount available for prompt cash payment at this facility.

Insurance Median

$361

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: $447 (200%)

Insurance Median: $361 (161%)

Cash: $447 (200% of Medicare)

Ins. Median: $361 (161% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$197 - $595	88%
Geisinger Health Plan	$197 - $925	88%
Medicare (plans)	$197	88%
Upmc Health Plan	$197 - $11,890	88%
Advantra	$199	89%
Humana	$199	89%
Aetna	$295 - $350	132%
Cigna	$312 - $379	139%
UnitedHealthcare	$319	143%
Christian Healthcare Ministries	$360	161%
Ambetter / Centene	$473	211%
Christian Health Aid	$577	258%
Three Rivers Provider Network Inc.	$577	258%
Multiplan	$613	274%
Healthsmart Payors Organization	$649	290%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $447.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 94640.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Geisinger-Lewistown Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 94640.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.