CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Winter Haven Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $122
  • Cash Discount Price: $92
  • vs. Medicare Baseline: 0.55x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Winter Haven Hospital is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.55x the Medicare baseline. Located in 200 Ave F Ne, Winter Haven, FL.
Cash / Self-Pay
$92

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $92 (41%)
Insurance Median: $122 (55%)
Cash: $92 (41% of Medicare)
Ins. Median: $122 (55% 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
Molina $28 - $90 13%
Simply Healthcare $28 - $43 13%
Clear Health Alliance $41 18%
UnitedHealthcare $42 - $218 19%
Freedom Health $43 19%
Humana $43 - $255 19%
Molina Healthcare $43 19%
Sunshine Health $43 19%
Aetna $44 - $235 20%
Florida Community Care $45 20%
Ultimate Health Plan $46 21%
Avmed $47 - $75 21%
Blue Cross Blue Shield $49 - $204 22%
Florida Hospital $70 31%
Evolutions $76 - $142 34%
Cigna $81 - $235 36%
Multiplan $122 55%
First Health $130 58%
Ambetter / Centene $153 - $521 68%
United Behavioral Health $153 68%
Baycareplus $204 91%
Careplus $219 98%
Solis Health $225 101%
Health First $235 105%
Freedom $236 105%
Optimum $236 105%
Wellcare $286 128%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Ave F Ne, Winter Haven, FL 33881
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals