CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Florida Fawcett Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $61
Cash Discount Price: $322
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Florida Fawcett Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $322. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.27x the Medicare baseline. Located in 21298 Olean Blvd, Port Charlotte, FL.

Cash / Self-Pay

$322

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $322 (144%)

Insurance Median: $61 (27%)

Cash: $322 (144% of Medicare)

Ins. Median: $61 (27% 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	$13 - $17	6%
Corvel Corporation	$18 - $94	8%
Prime Health	$18 - $96	8%
Rockport Healthcare Group	$18 - $94	8%
Access 2 Healthcare Physicians Freedom Health	$20 - $27	9%
Access 2 Healthcare Physicians Optimum	$20 - $27	9%
Freedom Health Care	$21 - $29	9%
Optimum Healthcare	$21 - $29	9%
Avmed	$22 - $92	10%
Truli	$23 - $31	10%
Blue Cross Blue Shield	$24 - $75	11%
Aetna	$40 - $111	18%
Simply Healthcare	$40 - $57	18%
Oscar	$41 - $55	18%
United	$45 - $166	20%
Cigna	$48 - $64	21%
Molina	$52 - $100	23%
Evolutions Healthcare Systems	$63 - $340	28%
Sunshine State Health Plan	$70 - $94	31%
Humana	$77 - $104	34%
Behealthy America	$107 - $144	48%
Healthcare Sarasota	$137 - $185	61%
Plotkin Health	$137 - $185	61%
Prime Health Sheriff	$137 - $185	61%
Multiplan	$205 - $314	92%

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 $322.
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 Fawcett 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.