CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Baptist Hospital of Miami

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $138
  • Cash Discount Price: $171
  • vs. Medicare Baseline: 0.62x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Baptist Hospital of Miami is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $171. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.62x the Medicare baseline. Located in 8900 N Kendall Dr, Miami, FL.
Cash / Self-Pay
$171

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $171 (76%)
Insurance Median: $138 (62%)
Cash: $171 (76% of Medicare)
Ins. Median: $138 (62% 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
Amerigroup $37 17%
Medicaid / KanCare $37 - $40 17%
Sunshine State $39 17%
UnitedHealthcare $39 - $297 17%
Wellcare $39 17%
Aetna $40 - $256 18%
Blue Cross Blue Shield $40 - $237 18%
Avmed $82 - $252 37%
Non Contracted $84 - $109 38%
Cigna $87 - $261 39%
Medicare (plans) $91 - $309 41%
Medica Health Plan $99 - $245 44%
Humana $100 - $249 45%
Leon Medical $102 - $256 46%
Amerihealth $104 - $134 46%
International $150 - $193 67%
Dimension Health Plan $172 - $267 77%
Vista $173 77%
Affordable $196 - $252 88%
Phcs $207 - $267 93%
Quality Health $207 - $267 93%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8900 N Kendall Dr, Miami, FL 33176
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals