CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Baptist Health Medical Center - Jacksonville

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $216
  • Cash Discount Price: $486
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Baptist Health Medical Center - Jacksonville is $216. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $486. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.97x the Medicare baseline. Located in 800 Prudential Dr, Jacksonville, FL.
Cash / Self-Pay
$486

Average discount available for prompt cash payment at this facility.

Insurance Median
$216

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: $486 (217%)
Insurance Median: $216 (97%)
Cash: $486 (217% of Medicare)
Ins. Median: $216 (97% 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
Corvel $19 8%
Coventry Workers Comp $19 8%
Non-Contracted $19 - $107 8%
Amerigroup Of Georgia $41 18%
Caresource Of Georgia $41 - $464 18%
Daniel Memorial $41 18%
Humana $41 - $45 18%
Peach State Health Plan $41 - $464 18%
Simply Healthcare Plans $43 - $49 19%
Simply Healthcare Plans - Cha $43 19%
Amerihealth Caritas $45 20%
Florida Community Care $45 - $214 20%
Sunshine State Health Plan $45 20%
United Community Plan $45 20%
Vivida Health $45 20%
Aetna $49 - $571 22%
Molina Healthcare Of Florida $49 22%
Blue Cross Blue Shield $143 - $464 64%
UnitedHealthcare $171 - $374 76%
Community Hospice Of Northeast Florida $203 - $204 91%
Pace $203 - $204 91%
Tomorrow'S Rainbow $203 - $204 91%
Va Ccn $203 - $204 91%
Devoted $216 97%
Upmc $224 - $225 100%
Avmed $228 - $371 102%
Cigna $278 - $436 124%
Borland Groover $286 128%
Occunet $286 - $357 128%
Northeast Florida State Hospital $300 - $336 134%
Centivo $314 - $607 140%
Capital Health Plan $328 147%
Innovative Healthware Services $336 150%
Geo Group $357 160%
Volusia Health Network $393 176%
Watchtower $393 176%
Fscj Student Insurance $428 191%
Suddath Company $450 201%
Medicaid / KanCare $464 207%
Ambetter / Centene $488 - $490 218%
Uf Health Proton Therapy Institute $500 223%
Phcs $536 - $571 240%
Evolutions Healthcare $643 287%
Multiplan $643 287%
Nemours Research $983 439%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Prudential Dr, Jacksonville, FL 32207
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals