CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Fishermen's Community Hospital

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 94640
  • Insurance Median: $168
  • Cash Discount Price: $193
  • vs. Medicare Baseline: 0.75x Medicare
The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Fishermen's Community Hospital is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.75x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.
Cash / Self-Pay
$193

Average discount available for prompt cash payment at this facility.

Insurance Median
$168

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: $193 (86%)
Insurance Median: $168 (75%)
Cash: $193 (86% of Medicare)
Ins. Median: $168 (75% 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
Amerigroup $36 16%
Medicaid / KanCare $36 - $39 16%
UnitedHealthcare $36 - $297 16%
Wellcare $37 17%
Sunshine State $38 17%
Aetna $39 - $228 17%
Vista $39 17%
Blue Cross Blue Shield $50 - $297 22%
Leon Medical $62 28%
Medica Health Plan $62 28%
Medicare (plans) $62 - $84 28%
Humana $68 30%
Avmed $69 - $246 31%
Cigna $71 - $238 32%
Non Contracted $109 49%
International $193 86%
Amerihealth $223 100%
Dimension Health Plan $223 - $267 100%
Affordable $267 119%
Phcs $267 119%
Quality Health $267 119%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3301 Overseas Hwy, Marathon, FL 33050
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals