CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Florida Oak Hill Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $116
Cash Discount Price: $760
vs. Medicare Baseline: 0.52x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Florida Oak Hill Hospital is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $760. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.52x the Medicare baseline. Located in 11375 Cortez Blvd, Brooksville, FL.

Cash / Self-Pay

$760

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $760 (340%)

Insurance Median: $116 (52%)

Cash: $760 (340% of Medicare)

Ins. Median: $116 (52% 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
Corvel Corporation	$18 - $97	8%
Prime Health	$18 - $100	8%
Rockport Healthcare Group	$18 - $97	8%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$36	16%
Access 2 Healthcare Physicians Freedom Health	$55	25%
Access 2 Healthcare Physicians Optimum	$55	25%
Freedom Health Care	$59	26%
Optimum Healthcare	$59	26%
Avmed	$61 - $190	27%
Blue Cross Blue Shield	$61 - $153	27%
Truli	$61 - $93	27%
Simply Healthcare	$96 - $117	43%
Aetna	$100 - $228	45%
Oscar	$114	51%
United	$125 - $342	56%
Cigna	$132	59%
Molina	$144 - $205	64%
Evolutions Healthcare Systems	$175 - $699	78%
Sunshine State Health Plan	$194	87%
Humana	$213	95%
Plotkin Health	$380	170%
Prime Health Sheriff	$380	170%
Multiplan	$570 - $646	255%

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 $760.
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 Oak Hill 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.