CMS Price Transparency Data

Breathing treatment (nebulizer)

Facility: Larkin Community Hospital Behavioral Health Srvs

Billing Code: 94640 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 94640
Insurance Median: $119
Cash Discount Price: $125
vs. Medicare Baseline: 0.53x Medicare

The contracted insurance negotiated median rate for a Breathing treatment (nebulizer) at Larkin Community Hospital Behavioral Health Srvs is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $223.72, this hospital’s rate is 0.53x the Medicare baseline. Located in 1201 N 37Th Ave, Hollywood, FL.

Cash / Self-Pay

$125

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $125 (56%)

Insurance Median: $119 (53%)

Cash: $125 (56% of Medicare)

Ins. Median: $119 (53% 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
Clear Spring Health-All Plans	$8 - $290	4%
Medicaid / KanCare	$33 - $61	15%
Miami Childrens Hp-All Plans	$33 - $61	15%
Sunshine Behav Mcaid	$33 - $61	15%
Community Care Plan-All Plans	$61	27%
Magellan Healthcare-All Plans	$177	79%
Bright Hlth Mcr Adv	$203	91%
Cigna	$206	92%
Bright Hlth Comm - All Other Plans	$214	96%
Longevity Mcr Adv-All Plans	$277	124%
Sunshine Behav Comm - All Other Plans	$277	124%
Aetna	$295	132%
Hma Mcr Adv	$318	142%

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 $125.
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 Larkin Community Hospital Behavioral Health Srvs 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.