CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Punxsutawney Area Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $207
  • Cash Discount Price: $289
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Punxsutawney Area Hospital is $207. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $289. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.93x the Medicare baseline. Located in 81 Hillcrest Drive, Punxsutawney, PA.
Cash / Self-Pay
$289

Average discount available for prompt cash payment at this facility.

Insurance Median
$207

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: $289 (129%)
Insurance Median: $207 (93%)
Cash: $289 (129% of Medicare)
Ins. Median: $207 (93% 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.

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
Highmark Wholecare $5 - $213 2%
Tricare $6 - $207 3%
Cigna $7 - $623 3%
UnitedHealthcare $7 - $604 3%
Aetna $8 - $503 4%
Ambetter / Centene $8 - $420 4%
Amerihealth Caritas $8 - $225 4%
Geisinger Health Plan $8 - $229 4%
Highmark $8 - $2,264 4%
United Mine Workers Of America $8 - $228 4%
Upmc Health Plan $8 - $240 4%
Pa Health And Wellness Commercial $10 - $457 4%
Geisinger $11 - $640 5%
Humana $225 101%
Pa Workers Compensation $491 - $1,049 219%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 81 Hillcrest Drive, Punxsutawney, PA 15767
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals