CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Santa Rosa Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $274
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Santa Rosa Medical Center is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.22x the Medicare baseline. Located in 6002 Berryhill Rd, Milton, FL.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$274

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: $120 (54%)
Insurance Median: $274 (122%)
Cash: $120 (54% of Medicare)
Ins. Median: $274 (122% 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
Veterans Eval Services $7 3%
Medicaid / KanCare $41 - $47 18%
Humana $42 - $225 19%
Wellcare $43 19%
Molina $46 21%
Fl Community Care $47 21%
UnitedHealthcare $66 - $8,567 30%
Cigna $77 - $9,980 34%
Self Pay $79 - $10,156 35%
Prime Health Work Comp Fl $94 42%
Florida Workers Compensation $97 43%
Aetna $124 - $24,773 55%
Tricare $217 - $3,215 97%
Blue Cross Blue Shield $225 - $5,934 101%
Medicare (plans) $225 101%
Hospice Of Nw Fl $229 - $22,079 102%
Node Champva $229 - $3,385 102%
Node Va $229 102%
Node Wellcare Mcr Adv $236 105%
Prime Health Services $274 - $35,326 122%
Geo Group $286 128%
Node Us Dept Of Labor $286 128%
Florida State Auto Insurance $457 204%
Ambetter / Centene $547 245%
Oscar $689 308%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6002 Berryhill Rd, Milton, FL 32570
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals