CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Penn State Health Hampden Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $200
Cash Discount Price: $64
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Penn State Health Hampden Medical Center is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.89x the Medicare baseline. Located in 2200 Good Hope Road, Enola, PA.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$200

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: $64 (29%)

Insurance Median: $200 (89%)

Cash: $64 (29% of Medicare)

Ins. Median: $200 (89% 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	$52 - $216	23%
[Upmc]	$74 - $218	33%
UnitedHealthcare	$76 - $214	34%
[Cbc]	$87 - $214	39%
Cigna	$125	56%
[Geisinger]	$136 - $214	61%
[Preferred Healthcare Systems]	$153	68%
[First Health]	$163	73%
[Multiplan]	$163	73%
[Amerihealth Caritas]	$182 - $214	81%
[Highmark Wholecare]	$182 - $214	81%
[Health Partners Plans]	$199 - $218	89%
[Pa Health & Wellness]	$200 - $220	89%
[Highmark]	$212 - $915	95%
Humana	$216	97%
[Healthspring]	$216	97%
[Point Comfort Underwriters]	$268	120%
[Highmark Choice Blue]	$732	327%
[Highmark Aca]	$768	343%

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 $64.
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 Penn State Health Hampden Medical Center 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.