CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Florida North Florida Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $66
  • Cash Discount Price: $261
  • vs. Medicare Baseline: 0.30x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Florida North Florida Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $261. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.30x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.
Cash / Self-Pay
$261

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: $261 (117%)
Insurance Median: $66 (30%)
Cash: $261 (117% 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.

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
Corvel Corporation $18 - $101 8%
Prime Health $18 - $104 8%
Careworks (Rockport Community) $19 - $107 8%
Blue Cross Blue Shield $28 - $66 13%
Avmed $31 - $131 14%
Oscar $31 - $32 14%
Simply Healthcare $33 15%
Aetna $38 - $79 17%
United $39 - $118 17%
Simply $40 18%
Cigna $45 - $109 20%
Molina Healthcare $49 - $84 22%
Humana $52 23%
Evolutions $60 27%
Sunshine State Health Plan $66 - $67 30%
Plotkin Health $130 - $131 58%
Prime Health Sheriff $130 - $131 58%
Corizon Phs $156 - $158 70%
Multiplan $203 - $223 91%
Evernorth $208 - $210 93%
Evolutions Healthcare $221 - $223 99%
Ppo Next $221 - $223 99%
Novanet $234 - $236 105%
Beacon Health Options $260 - $262 116%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6500 W Newberry Rd, Gainesville, FL 32605
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals