CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Florida Twin Cities Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $139
Cash Discount Price: $457
vs. Medicare Baseline: 0.62x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Florida Twin Cities Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $457. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.62x the Medicare baseline. Located in 2190 Hwy 85 N, Niceville, FL.

Cash / Self-Pay

$457

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $457 (204%)

Insurance Median: $139 (62%)

Cash: $457 (204% of Medicare)

Ins. Median: $139 (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.

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
Corvel Corporation	$18 - $97	8%
Prime Health	$18 - $99	8%
Careworks (Rockport Community)	$19 - $102	8%
Blue Cross Blue Shield	$39 - $145	17%
Oscar	$46 - $73	21%
Simply	$55 - $86	25%
Simply Healthcare	$59 - $93	26%
Cigna	$62 - $232	28%
Molina Healthcare	$67 - $179	30%
Avmed	$85 - $279	38%
United	$85 - $251	38%
Sunshine State Health Plan	$91 - $142	41%
Aetna	$104 - $227	46%
Humana	$135 - $212	60%
Plotkin Health	$178 - $279	80%
Prime Health Sheriff	$178 - $279	80%
Evolutions Healthcare	$231 - $474	103%
Multiplan	$277 - $474	124%
Ppo Next	$302 - $474	135%
Novanet	$320 - $502	143%

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 $457.
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 HCA Florida Twin Cities Hospital 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.