CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Florida Kendall Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $139
Cash Discount Price: $711
vs. Medicare Baseline: 0.62x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Florida Kendall Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $711. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.62x the Medicare baseline. Located in 11750 Bird Rd, Miami, FL.

Cash / Self-Pay

$711

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $711 (318%)

Insurance Median: $139 (62%)

Cash: $711 (318% of Medicare)

Ins. Median: $139 (62% 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	$24 - $183	11%
Optimum	$24 - $98	11%
Blue Cross Blue Shield	$29 - $263	13%
Avmed	$33 - $572	15%
Simply Healthcare Plans	$36 - $149	16%
Aetna	$37 - $344	17%
Simply Healthcare	$37 - $155	17%
Oscar	$44 - $183	20%
Amerihealth Caritas	$47 - $195	21%
Molina	$53 - $309	24%
Cigna	$58 - $240	26%
Humana	$58 - $389	26%
Health Sun Health Plan	$59 - $244	26%
Aids Healthcare	$61 - $1,374	27%
Mmm Of Fl (Health Advantage Plan)	$64 - $263	29%
United Ppo	$66 - $271	30%
Sunshine State Health Plan	$72 - $298	32%
United	$125 - $515	56%
Plotkin Health	$138 - $572	62%
Prime Health Sherriff	$138 - $572	62%
Medica Healthcare	$161 - $664	72%
Multiplan	$208 - $973	93%
Evernorth Bh	$222 - $916	99%

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 $711.
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 Kendall 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.