Breathing treatment (nebulizer)
Facility: Lancaster General Hospital
Billing Code: 94640 (CPT)
- CPT Billing Code: 94640
- Insurance Median: $158
- Cash Discount Price: $166
- vs. Medicare Baseline: 0.71x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $18 - $434 | 8% |
| Hospice And Community Care | $26 - $69 | 12% |
| Upmc For You | $35 - $91 | 16% |
| Old Order Group | $38 - $116 | 17% |
| Lg Coresource/Lg Eliance | $40 - $103 | 18% |
| Lancashire Hall | $42 - $363 | 19% |
| Nursing Home Op Services | $42 - $109 | 19% |
| Blue Cross Blue Shield | $45 - $309 | 20% |
| Affilia Home Health | $56 - $363 | 25% |
| Masonic Homes | $58 - $363 | 26% |
| Highmark | $67 - $363 | 30% |
| Gateway | $70 - $182 | 31% |
| Tricare | $83 - $200 | 37% |
| Eliance Health Solutions | $89 - $232 | 40% |
| Highmark Commercial Preferred | $93 - $363 | 42% |
| Aetna | $94 - $246 | 42% |
| Cigna | $105 - $304 | 47% |
| Ehp | $114 - $298 | 51% |
| Upmc Commercial | $114 - $309 | 51% |
| Devon | $118 - $309 | 53% |
| Geisinger Commercial | $118 - $309 | 53% |
| Intergroup Services | $118 - $309 | 53% |
| Preferred Healthcare | $118 - $309 | 53% |
| UnitedHealthcare | $118 - $309 | 53% |
| Medi-Share Christian Care | $132 - $345 | 59% |
| Commercial Generic | $139 - $363 | 62% |
| Highmark Commercial Non-Preferred | $139 - $366 | 62% |
| Magellan | $139 - $363 | 62% |
| Pa Health And Wellness Mcr | $139 - $234 | 62% |
| United Behavioral Health | $139 - $363 | 62% |
| Value Options | $139 - $363 | 62% |
| Workers Compensation | $139 - $363 | 62% |
| Albright Life | $222 | 99% |
| Coatesville Va | $222 | 99% |
| Hospice Generic | $222 | 99% |
| Lebanon Veterans Hospital | $222 | 99% |
| Medicare (plans) | $222 - $246 | 99% |
| Amerihealth Caritas | $227 | 101% |
| Health Partners Mcr Advantage | $229 | 102% |
| Devoted Health | $234 | 105% |
| Elap Employees | $316 | 141% |
| Oscar Health Plan | $434 | 194% |
| Claim Watcher Plus | $667 | 298% |
| Claim Watcher | $734 | 328% |
| Elap Other Groups | $810 | 362% |
| Gift Of Life Donor Program | $13,500 | 6034% |