CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Wellspan Good Samaritan Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $232
Cash Discount Price: $310
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Wellspan Good Samaritan Hospital is $232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $310. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.04x the Medicare baseline. Located in 252 South 4Th Street, Lebanon, PA.

Cash / Self-Pay

$310

Average discount available for prompt cash payment at this facility.

Insurance Median

$232

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: $310 (139%)

Insurance Median: $232 (104%)

Cash: $310 (139% of Medicare)

Ins. Median: $232 (104% 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
Aetna	$70 - $314	31%
Blue_Cross	$158 - $226	71%
Medicare (plans)	$201 - $217	90%
Geisinger	$232	104%
Upmc	$232	104%
Wellspan_Capital_Blue_Cross	$232	104%
Cigna	$247	110%
Phc	$310	139%
Highmark	$311 - $732	139%
Medicaid / KanCare	$332 - $352	148%
First_Health_Network	$346	155%
United_Healthcare	$363	162%

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 $310.
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 Wellspan Good Samaritan 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.