CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Shands Jacksonville

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $251
  • Cash Discount Price: $257
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Shands Jacksonville is $251. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $257. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.12x the Medicare baseline. Located in 655 W 8Th St, Jacksonville, FL.
Cash / Self-Pay
$257

Average discount available for prompt cash payment at this facility.

Insurance Median
$251

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: $257 (115%)
Insurance Median: $251 (112%)
Cash: $257 (115% of Medicare)
Ins. Median: $251 (112% 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
Aetna $41 - $408 18%
Carelon Health $45 20%
Humana $45 - $421 20%
Simply Healthcare $45 20%
Florida Community Care $47 21%
Amerihealth Caritas Florida $49 22%
Community Care Plan $49 22%
Molina $49 - $265 22%
Blue Cross Blue Shield $130 - $971 58%
UnitedHealthcare $184 - $407 82%
Volusia Health Network $185 - $208 83%
Northeast Florida State Hospital $194 - $218 87%
North Florida Evaluation & Treatment Center $207 - $233 93%
Capital Health Plan $220 - $248 98%
Positive Healthcare Partners $225 - $252 101%
Ameri-Plus Preferred Care $229 102%
Beacon Health Strategies $236 105%
Careplus Health Plan $236 105%
Florida Health Care Plan $236 - $367 105%
Devoted Health Plan $240 - $252 107%
Centivo $242 - $273 108%
Avmed $247 - $278 110%
Disney Cruise Line $264 - $297 118%
Wellcare Of Florida $268 120%
Cigna $273 - $307 122%
Florida Complete Care $286 128%
Health First Health Plan $286 - $372 128%
Mental Health Associates $286 - $322 128%
Prime Health Services $308 - $372 138%
Florida Health Alliance $317 - $357 142%
Archbold Medical Center $330 - $372 148%
Genex $330 - $372 148%
Rockport Provider $330 - $372 148%
Wellpath $337 151%
Ambetter / Centene $339 152%
Corvel Corp $374 - $421 167%
First Health $374 - $421 167%
Florida Hospital Healthcare System $374 - $421 167%
Medsave Usa Tpa $374 - $421 167%
Truli For Health $375 168%
Fringe Benefits Coordinators $396 - $471 177%
Multiplan $396 - $446 177%
Novanet $396 - $446 177%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 655 W 8Th St, Jacksonville, FL 32209
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals