CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: HCA Florida Palms West Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $134
Cash Discount Price: $633
vs. Medicare Baseline: 0.60x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at HCA Florida Palms West Hospital is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $633. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.60x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.

Cash / Self-Pay

$633

Average discount available for prompt cash payment at this facility.

Insurance Median

$134

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: $633 (283%)

Insurance Median: $134 (60%)

Cash: $633 (283% of Medicare)

Ins. Median: $134 (60% 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)	$19 - $103	8%
Corvel Corporation	$19 - $101	8%
Prime Health	$19 - $103	8%
Freedom Health	$54 - $101	24%
Optimum	$54	24%
Blue Cross Blue Shield	$63 - $143	28%
Avmed	$82 - $316	37%
Simply Healthcare Plans	$82	37%
Simply Healthcare	$85	38%
Aetna	$99 - $190	44%
Oscar	$101	45%
Amerihealth Caritas	$108	48%
Molina	$120 - $171	54%
Cigna	$133	59%
Humana	$133 - $215	59%
Health Sun Health Plan	$135	60%
Aids Healthcare	$139 - $760	62%
Mmm Of Fl (Health Advantage Plan)	$146	65%
United Ppo	$150	67%
Sunshine State Health Plan	$165	74%
United	$285	127%
Health Care District	$316	141%
Palm Beach Juvenile Correction	$316	141%
Plotkin Health	$316	141%
Prime Health Sherriff	$316	141%
Medica Healthcare	$367	164%
Multiplan	$475 - $538	212%
Healthy Palm Beaches	$550	246%

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 $633.
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 Palms West 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.