CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Memorial Hospital West

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $165
  • Cash Discount Price: $205
  • vs. Medicare Baseline: 0.74x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Memorial Hospital West is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $205. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.74x the Medicare baseline. Located in 703 N Flamingo Rd, Pembroke Pines, FL.
Cash / Self-Pay
$205

Average discount available for prompt cash payment at this facility.

Insurance Median
$165

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: $205 (92%)
Insurance Median: $165 (74%)
Cash: $205 (92% of Medicare)
Ins. Median: $165 (74% 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
Avmed $7 - $166 3%
Amerihealth Caritas $8 - $86 4%
Community Care Plan $8 - $91 4%
Molina $9 - $97 4%
Aetna $10 - $254 4%
Health Value Management $17 - $236 8%
UnitedHealthcare $20 - $274 9%
Sunshine $21 - $434 9%
Emerging Therapy Solutions $29 - $323 13%
Allianz $32 - $350 14%
Axis $32 - $350 14%
Desjardins Financial Security Life Assurance Company $32 - $350 14%
Global Health Claims $32 - $457 14%
Global Medical Management $32 - $350 14%
Global Reach Health $32 - $350 14%
National Healthcare Solutions $32 - $350 14%
Plotkin $32 - $350 14%
Quality Health Management $32 - $350 14%
Quebec Inc $32 - $350 14%
Star Healthcare Network $32 - $350 14%
World Medical Care $32 - $350 14%
Worldwide Managed Care Partners $32 - $350 14%
Worldwide Medical Assurance $32 - $350 14%
Dimension Health $33 - $363 15%
Health Sun $37 - $404 17%
Gallagher Bassett $39 - $430 17%
Cigna $93 - $251 42%
Corvel $106 47%
Employers Choice Network $106 47%
First Health $106 47%
Prime Health Services $106 47%
Employers Health Network $172 77%
Wellcare $242 - $249 108%
Florida Community Care $245 110%
Humana $247 110%
Solis Health Plan $258 115%
Florida Pace Centers $263 118%
Align Senior Care $279 125%
Longevity $286 128%
Broward County $718 - $2,726 321%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 703 N Flamingo Rd, Pembroke Pines, FL 33028
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals