CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Larkin Community Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $102
  • Cash Discount Price: $125
  • vs. Medicare Baseline: 0.46x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Larkin Community Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.46x the Medicare baseline. Located in 7031 Sw 62Nd Ave, South Miami, FL.
Cash / Self-Pay
$125

Average discount available for prompt cash payment at this facility.

Insurance Median
$102

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: $125 (56%)
Insurance Median: $102 (46%)
Cash: $125 (56% of Medicare)
Ins. Median: $102 (46% 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
Medicare (plans) $6 - $310 3%
Aetna $8 - $295 4%
Fci-All Plans $8 - $235 4%
Global Excel-All Plans $8 - $177 4%
Clear Springs Hlth-All Plans $9 - $214 4%
Fdc-All Plans $10 4%
UnitedHealthcare $11 - $276 5%
Medicaid / KanCare $29 - $61 13%
Corvel Mcaid Workers Comp $37 17%
Sunshine Behavioral $37 17%
Jipa Network-All Plans $40 18%
Ambetter / Centene $41 18%
Community Care Phks Mcaid-All Other Plans $41 18%
Florida Comm Care Mcaid $41 18%
Humana $41 - $295 18%
Magellan Complete Care $41 18%
Molina Exch Marketplace-All Other Plans $41 18%
Avmed-All Plans $61 - $295 27%
Bright Health-All Other Plans $61 - $354 27%
Coventry Comml-All Plans $61 - $295 27%
Cigna $74 33%
Jmh Health Plan Hmo/Ppo-All Other Plans $75 - $162 34%
United Prop Casualty-All Plans $86 - $102 38%
Healthsun-All Plans $88 39%
Star Network-All Plans $118 53%
Haa Preferred Partners-All Plans $177 79%
Blue Cross Blue Shield $191 - $387 85%
Florida Comm Care Mcare-All Other Plans $204 91%
Ops Maritime-All Plans $204 91%
Opus Hospice Ip Only-All Plans $204 91%
Preferred Care Partners Mcare-All Plans $204 91%
Unicare Simply Mcare Ppo-All Plans $214 96%
Wellpath-All Plans $225 101%
Allianz (Azga)-All Plans $265 118%
Corvel Mcare Workers Comp-All Plans $266 119%
Careplus Health-All Other Plans $295 132%
Centurion-All Plans $295 132%
Doctors Healthcare-All Plans $295 132%
First Med Hp Of Fl-All Plans $295 132%
Florida Health Solution/Hmo-All Plans $295 132%
Oscar Health-All Plans $590 264%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7031 Sw 62Nd Ave, South Miami, FL 33143
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals