CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Florida St Petersburg Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $66
Cash Discount Price: $499
vs. Medicare Baseline: 0.30x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Florida St Petersburg Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $499. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.30x the Medicare baseline. Located in 6500 38Th Ave N, Saint Petersburg, FL.

Cash / Self-Pay

$499

Average discount available for prompt cash payment at this facility.

Insurance Median

$66

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: $499 (223%)

Insurance Median: $66 (30%)

Cash: $499 (223% of Medicare)

Ins. Median: $66 (30% 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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$9 - $38	4%
Access 2 Healthcare Physicians Freedom Health	$13 - $59	6%
Access 2 Healthcare Physicians Optimum	$13 - $59	6%
Freedom Health Care	$14 - $64	6%
Optimum Healthcare	$14 - $64	6%
Avmed	$15 - $204	7%
Blue Cross Blue Shield	$15 - $170	7%
Suncoast Neighborly Care	$15 - $65	7%
Truli	$15 - $99	7%
Corvel Corporation	$18 - $97	8%
Prime Health	$18 - $100	8%
Rockport Healthcare Group	$18 - $97	8%
Simply Healthcare	$23 - $126	10%
Oscar	$27 - $122	12%
Aetna	$29 - $244	13%
United	$30 - $367	13%
Cigna	$33 - $147	15%
Molina	$35 - $220	16%
Evolutions Healthcare Systems	$42 - $750	19%
Sunshine State Health Plan	$47 - $208	21%
Humana	$51 - $228	23%
Plotkin Health	$91 - $407	41%
Prime Health Sheriff	$91 - $407	41%
Multiplan	$137 - $693	61%

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 $499.
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 St Petersburg 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.