CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Lakeside Medical Center

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $204
Cash Discount Price: $204
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Lakeside Medical Center is $204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $204. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.91x the Medicare baseline. Located in 39200 Hooker Hwy, Belle Glade, FL.

Cash / Self-Pay

$204

Average discount available for prompt cash payment at this facility.

Insurance Median

$204

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: $204 (91%)

Insurance Median: $204 (91%)

Cash: $204 (91% of Medicare)

Ins. Median: $204 (91% 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
Aetna	$15 - $314	7%
Cigna	$15 - $204	7%
UnitedHealthcare	$67 - $204	30%
Heritage Summit Healthcare	$106	47%
Blue Cross Blue Shield	$127 - $358	57%
Geo	$194	87%
Care Plus	$204	91%
Humana	$204	91%
Molina	$204 - $214	91%
Simply Healthcare	$204	91%
Wellpath	$204	91%
Ambetter / Centene	$214	96%
Sunshine	$214	96%
Wellcare	$214	96%
Devoted	$218	97%
Prime Health Plan	$224	100%
Genesys	$225	101%

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 $204.
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 Lakeside Medical Center 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.