CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Tampa General Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $249
Cash Discount Price: $281
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Tampa General Hospital is $249. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $281. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 1.11x the Medicare baseline. Located in 1 Tampa General Cir, Tampa, FL.

Cash / Self-Pay

$281

Average discount available for prompt cash payment at this facility.

Insurance Median

$249

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: $281 (126%)

Insurance Median: $249 (111%)

Cash: $281 (126% of Medicare)

Ins. Median: $249 (111% 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
Capital Health Plan Tallahassee	$229	102%
Aetna	$231	103%
Blue Cross Blue Shield	$232	104%
Care Plus Health Plans	$232	104%
Freedom Health	$233	104%
Baycare	$236	105%
Ultimate Health Plans	$240	107%
Simply Healthcare	$242 - $384	108%
Cigna	$245	110%
Longevity	$249	111%
Kaiser	$252	113%
Devoted Health	$256	114%
Molina	$343	153%
Sunshine Health	$346 - $366	155%
Health First Health Plans	$412	184%
Truli For Health	$434	194%
Oscar	$457	204%

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 $281.
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 Tampa General 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.