CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $27
  • Cash Discount Price: $377
  • vs. Medicare Baseline: 0.12x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Cleveland Clinic Indian River Hospital is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $377. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.12x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.
Cash / Self-Pay
$377

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

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: $377 (169%)
Insurance Median: $27 (12%)
Cash: $377 (169% of Medicare)
Ins. Median: $27 (12% 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
UnitedHealthcare $7 3%
Amerihealth $8 4%
Avmed $8 - $468 4%
Blue Cross Blue Shield $8 - $204 4%
Careplus $8 - $204 4%
Freedom Health $8 - $204 4%
Independent Living Systems $8 - $214 4%
Magellan $8 - $610 4%
Medicaid / KanCare $8 4%
Molina $8 4%
United $8 - $1,194 4%
Value Options $8 4%
Wellcare $8 - $204 4%
Wellmed $8 - $204 4%
Clear Spring Health $9 - $12 4%
Aetna $10 - $814 4%
Cigna $21 - $305 9%
Clarity Health $93 - $661 42%
The Legacy Companies $93 - $661 42%
National Provider Network $100 45%
Three Rivers $100 45%
Consociate Health $107 48%
Carelon Bh Strategies $204 91%
Humana $204 91%
Devoted Health $225 101%
Bmi $559 250%
Multiplan $814 364%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 36Th St, Vero Beach, FL 32960
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals