CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Florida Mercy Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $111
Cash Discount Price: $523
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Florida Mercy Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $523. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.50x the Medicare baseline. Located in 401 Nw 42Nd Ave, Plantation, FL.

Cash / Self-Pay

$523

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $523 (234%)

Insurance Median: $111 (50%)

Cash: $523 (234% of Medicare)

Ins. Median: $111 (50% 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
Careworks (Rockport)	$20 - $107	9%
Corvel Corporation	$20 - $105	9%
Prime Health	$20 - $107	9%
Freedom Health	$45 - $84	20%
Optimum	$45	20%
Blue Cross Blue Shield	$52 - $118	23%
Avmed	$63 - $262	28%
Simply Healthcare Plans	$68	30%
Aetna	$76 - $157	34%
Oscar	$84	38%
Amerihealth Caritas	$89	40%
Molina	$99 - $141	44%
Cigna	$110	49%
Humana	$110 - $178	49%
Health Sun Health Plan	$111	50%
Aids Healthcare	$115 - $628	51%
Mmm Of Fl (Health Advantage Plan)	$120	54%
United Ppo	$124	55%
Sunshine State Health Plan	$136	61%
United	$235	105%
Plotkin Health	$262	117%
Prime Health Sherriff	$262	117%
Medica Healthcare	$309	138%
Multiplan	$392 - $445	175%
Evernorth Bh	$418	187%

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 $523.
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 HCA Florida Mercy 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.