CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: UPMC Hamot

Billing Code: 94640 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$172

about 0.8× the $224 Medicare rate · typically $27–$231

modeled estimate · not a bill or quote

What this hospital charges insurers

$228

Above the fair price

about $56 over the fair price · 1.0× Medicare

Medicare pays $224 Fair price $172 This hospital $228 Cash price $617 Hospital's list price $1,029

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $25 Priciest $228

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

A fair price for a Breathing treatment (nebulizer) is about $172 (about 0.8× the $224 Medicare rate). UPMC Hamot charges insurers about $228, or about $617 in cash — above the fair price. Located in Erie, PA.

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 $172. 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.

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

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	$239 - $468	107%
Blue Cross Blue Shieldmajor	$25 - $514	11%
Aetnamajor	$228 - $720	102%
Cignamajor	$242 - $412	108%
AmeriHealth	$242	108%
Fidelis Care	$224	100%
Geisinger	$566	253%
UPMC Health Plan	$33 - $228	15%
WellCare	$230	103%
+ 3 smaller / regional plans	$154 - $823

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 617), 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 UPMC Hamot 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 UPMC Hamot

Compare: Breathing treatment (nebulizer) at other PA hospitals

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