CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Larkin Community Hospital Palm Springs Campus

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $70
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 0.31x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Larkin Community Hospital Palm Springs Campus is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.31x the Medicare baseline. Located in 1475 W 49Th St, Hialeah, FL.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $47 (21%)
Insurance Median: $70 (31%)
Cash: $47 (21% of Medicare)
Ins. Median: $70 (31% 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
Bright Health Commercial - All Other Plans $10 - $274 4%
Clear Springs Health - All Plans $10 - $240 4%
Medicare (plans) $10 - $288 4%
Cigna $16 - $72 7%
Humana $20 - $288 9%
Wellcare Comm (Choice) - All Other Plans $32 - $144 14%
Simply Healthcare Mcaid $35 16%
United Mcaid $35 16%
Aetna $41 - $229 18%
Florida Community Care Mcaid-All Plans $41 18%
Miami Childrens Hp Mcaid-All Plans $41 18%
Sunshine Mcaid $41 18%
Wellcare Mcaid $41 18%
Leon Med Center Mcr Adv - All Plans $58 - $259 26%
Careplus Health - All Other Plans $65 - $288 29%
Centurion Doc - All Plans $65 - $288 29%
Doctors Healthcare - All Plans $65 - $288 29%
Florida Health Solution/Hmo - All Plans $65 - $288 29%
Preferred Care Partners Mcr - All Plans $65 - $288 29%
Simply Healthcare Mcr - All Other Plans $65 - $288 29%
UnitedHealthcare $65 - $288 29%
Naphcare - All Plans $75 - $331 34%
Oscar Health-All Plans $130 - $576 58%
Blue Cross Blue Shield $191 - $387 85%
Ambetter / Centene $229 102%
Opus Hospice Ip Only - All Plans $229 102%
Unicare Simply Mcare Ppo - All Plans $240 107%
Ccs - All Plans $309 138%
Fdc - All Plans $320 143%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1475 W 49Th St, Hialeah, FL 33012
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals