CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Florida Northside Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $34
  • Cash Discount Price: $190
  • vs. Medicare Baseline: 0.15x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Florida Northside Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.15x the Medicare baseline. Located in 6000 49Th St N, Saint Petersburg, FL.
Cash / Self-Pay
$190

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $190 (85%)
Insurance Median: $34 (15%)
Cash: $190 (85% of Medicare)
Ins. Median: $34 (15% 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
Access 2 Healthcare Physicians Freedom Optimum Group Members $9 4%
Access 2 Healthcare Physicians Freedom Health $14 6%
Access 2 Healthcare Physicians Optimum $14 6%
Avmed $15 - $48 7%
Freedom Health Care $15 7%
Optimum Healthcare $15 7%
Suncoast Neighborly Care $15 7%
Blue Cross Blue Shield $17 - $40 8%
Truli $17 - $23 8%
Corvel Corporation $18 - $97 8%
Prime Health $18 - $100 8%
Rockport Healthcare Group $18 - $97 8%
Simply Healthcare $24 - $29 11%
Oscar $29 13%
Aetna $30 - $57 13%
United $31 - $86 14%
Cigna $34 15%
Molina $36 - $51 16%
Evolutions Healthcare Systems $44 - $175 20%
Sunshine State Health Plan $48 21%
Humana $53 24%
Plotkin Health $95 42%
Prime Health Sheriff $95 42%
Multiplan $143 - $162 64%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6000 49Th St N, Saint Petersburg, FL 33709
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals