CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: UPMC Muncy

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $179
Cash Discount Price: $200
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at UPMC Muncy is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $200. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.80x the Medicare baseline. Located in 215 East Water Street, Muncy, PA.

Cash / Self-Pay

$200

Average discount available for prompt cash payment at this facility.

Insurance Median

$179

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: $200 (89%)

Insurance Median: $179 (80%)

Cash: $200 (89% of Medicare)

Ins. Median: $179 (80% 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
Highmark Wholecare (Prev Gateway)	$31 - $72	14%
Upmc Health Plan	$31 - $208	14%
Amerihealth Caritas	$32 - $2,208	14%
Cigna	$33 - $327	15%
UnitedHealthcare	$33 - $327	15%
Pa Health & Wellness	$34 - $2,316	15%
Upmc Work Partners	$38	17%
Three Rivers Provider Network	$41 - $430	18%
Blue Cross Blue Shield	$82 - $221	37%
Aetna	$84 - $315	38%
Coventry/First Health	$104 - $322	46%
Wirerope Works	$116 - $266	52%
Geisinger	$139 - $320	62%
Multiplan	$162 - $454	72%
America'S Choice	$166 - $382	74%
Intergroup	$166 - $382	74%

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 $200.
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 UPMC Muncy 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.